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NPI Code Detail

MEDICARE: JUDITKA LOURDES AGUILAR FUSTER BSPHARM

MEDICARE: JUDITKA LOURDES AGUILAR FUSTER BSPHARM
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
1183700000XPharmacy TechnicianPSI36869FL

General Provider Information

NPI Number : 1801530423
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDITKA LOURDES AGUILAR FUSTER BSPHARM
Provider Business Mailing Address
First Line : 4733 W WATERS AVE APT 1823
Second Line :
City : TAMPA
State : FL
Zip : 33614-1463
Country : US
Telephone Number : 813-475-2708
Fax Number :
Provider Business Practice Location Address
First Line : 12085 W HILLSBOROUGH AVE
Second Line :
City : TAMPA
State : FL
Zip : 33635-9725
Country : US
Telephone Number : 813-852-5270
Fax Number : 813-537-3602
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2022
Last Update Date : 04/21/2022

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Directions to “ JUDITKA LOURDES AGUILAR FUSTER BSPHARM” Practice Location

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