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NPI Code Detail

MEDICARE: DR. ADAM LEE WALTERS PHARM.D.

MEDICARE: DR. ADAM LEE WALTERS 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
1183500000XPharmacistPS51469FL

General Provider Information

NPI Number : 1881091403
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ADAM LEE WALTERS PHARM.D.
Provider Business Mailing Address
First Line : 3206 LANTANA RD
Second Line :
City : LANTANA
State : FL
Zip : 33462-2432
Country : US
Telephone Number : 318-237-9564
Fax Number :
Provider Business Practice Location Address
First Line : 3206 LANTANA RD
Second Line :
City : LANTANA
State : FL
Zip : 33462-2432
Country : US
Telephone Number : 318-237-9564
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2014
Last Update Date : 11/25/2014

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