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NPI Code Detail

MEDICARE: ERICA ENGWALL BURKE RPH

MEDICARE: ERICA ENGWALL BURKE RPH
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
1183500000XPharmacistPS23390FL

General Provider Information

NPI Number : 1871005033
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA ENGWALL BURKE RPH
Provider Business Mailing Address
First Line : 1700 NW 80TH BLVD
Second Line :
City : GAINESVILLE
State : FL
Zip : 32606-9177
Country : US
Telephone Number : 352-222-1970
Fax Number :
Provider Business Practice Location Address
First Line : 1700 NW 80TH BLVD
Second Line :
City : GAINESVILLE
State : FL
Zip : 32606-9177
Country : US
Telephone Number : 352-222-1970
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2017
Last Update Date : 10/27/2017

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Directions to “ ERICA ENGWALL BURKE RPH” Practice Location

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