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NPI Code Detail

MEDICARE: AQUAIEL TROUPE PHARMACIST INTERN

MEDICARE: AQUAIEL TROUPE PHARMACIST INTERN
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
1390200000XStudent in an Organized Health Care Education/Training ProgramPSI36583FL

General Provider Information

NPI Number : 1801314109
Entity Type Code : Individual
Provider Name (Legal Business Name) : AQUAIEL TROUPE PHARMACIST INTERN
Provider Business Mailing Address
First Line : 600 KINGSTON ST S
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33711-2129
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1075 PASADENA AVE S
Second Line :
City : SOUTH PASADENA
State : FL
Zip : 33707-2037
Country : US
Telephone Number : 727-347-4526
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2017
Last Update Date : 09/07/2017

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Directions to “ AQUAIEL TROUPE PHARMACIST INTERN” Practice Location

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