MEDICARE: DR. JOSEPH GEORGE CELENTO PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS53945	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PS53945	OTHER	FL	STATE OF FLORIDA DEPARTMENT OF HEALTH

General Provider Information

NPI Number	:	1760911705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH GEORGE CELENTO PHARM.D.

Provider Business Mailing Address
First Line	:	4780 N KINGS HWY
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34951-4035
Country	:	US
Telephone Number	:	772-489-2100
Fax Number	:	772-489-6403

Provider Business Practice Location Address
First Line	:	4780 N KINGS HWY
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34951-4035
Country	:	US
Telephone Number	:	772-489-2100
Fax Number	:	772-489-6403

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2017
Last Update Date	:	06/04/2017

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Directions to “ DR. JOSEPH GEORGE CELENTO PHARM.D.” Practice Location

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