MEDICARE: THE APOTHECARY OF GULFPORT

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	PS15676	FL
2	333600000X	Pharmacy	PH1331	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1048861	OTHER	FL	NABP

General Provider Information

NPI Number	:	1780668087
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE APOTHECARY OF GULFPORT

Provider Business Mailing Address
First Line	:	5802 28TH AVE S
Second Line	:
City	:	GULFPORT
State	:	FL
Zip	:	33707-5227
Country	:	US
Telephone Number	:	727-321-3000
Fax Number	:	727-344-5620

Provider Business Practice Location Address
First Line	:	5802 28TH AVE S
Second Line	:
City	:	GULFPORT
State	:	FL
Zip	:	33707-5227
Country	:	US
Telephone Number	:	727-321-3000
Fax Number	:	727-344-5620

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JOHN V KELLEY
Credential	:	R.PH.
Telephone Number	:	727-321-3000

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	03/08/2012

Similar Medicare Providers

1861209900 — DANIELLE BLECH L.AC.
Practice Location Address:

2838 BEACH BLVD S
GULFPORT, FL
33707-5587

Practice Phone: 727-371-6077
Practice Fax:

1720082688 — BOCA CIEGA REHABILITATION CENTER, LLC
Practice Location Address:

1414 59TH ST S
GULFPORT, FL
33707-3352

Practice Phone: 727-344-4608
Practice Fax: 727-345-0189

1164416004 — MS. KRISTEN M. HARRIS PT, GCS
Practice Location Address:

5126 31ST AVE S
GULFPORT, FL
33707-5622

Practice Phone: 727-350-1012
Practice Fax: 727-350-1012

1720072580 — MOBILE THERAPY, INC
Practice Location Address:

5126 31ST AVE S
GULFPORT, FL
33707-5622

Practice Phone: 727-350-1012
Practice Fax: 727-350-1012

1699760181 — GIOVANNI M. BAULA M.D.
Practice Location Address:

2849 SEABREEZE DR S
GULFPORT, FL
33707-3931

Practice Phone: 727-000-0000
Practice Fax:

1215928478 — JEFFREY L. PAONESSA MD
Practice Location Address:

6112 KIPPS COLONY DR W
GULFPORT, FL
33707-3970

Practice Phone: 727-347-3610
Practice Fax:

Directions to “THE APOTHECARY OF GULFPORT ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.