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NPI Code Detail

MEDICARE: CHARLES SPAGNUOLO PHARM D

MEDICARE: CHARLES SPAGNUOLO 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
1183500000XPharmacistPS49024FL

General Provider Information

NPI Number : 1891032678
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES SPAGNUOLO PHARM D
Provider Business Mailing Address
First Line : 670 MARSH LANDING PKWY
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32250-5850
Country : US
Telephone Number : 904-273-7606
Fax Number : 904-273-7612
Provider Business Practice Location Address
First Line : 670 MARSH LANDING PKWY
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32250-5850
Country : US
Telephone Number : 904-273-7606
Fax Number : 904-273-7612
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2013
Last Update Date : 01/14/2013

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