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NPI Code Detail

MEDICARE: DR. MICHAEL CARMEN LARUSSA III PHARM D.

MEDICARE: DR. MICHAEL CARMEN LARUSSA III 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
1183500000XPharmacistPS46348FL

General Provider Information

NPI Number : 1841537917
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL CARMEN LARUSSA III PHARM D.
Provider Business Mailing Address
First Line : 2038 US HIGHWAY 98 W
Second Line :
City : SANTA ROSA BEACH
State : FL
Zip : 32459-5322
Country : US
Telephone Number : 850-267-1166
Fax Number : 850-267-1761
Provider Business Practice Location Address
First Line : 2038 US HIGHWAY 98 W
Second Line :
City : SANTA ROSA BEACH
State : FL
Zip : 32459-5322
Country : US
Telephone Number : 850-267-1166
Fax Number : 850-267-1761
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2013
Last Update Date : 01/21/2013

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Directions to “ DR. MICHAEL CARMEN LARUSSA III PHARM D.” Practice Location

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