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NPI Code Detail

MEDICARE: DR. ROBERT DEXTRELL BLISS PHARM D

MEDICARE: DR. ROBERT DEXTRELL BLISS 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
1183500000XPharmacistPS39376FL

General Provider Information

NPI Number : 1942571906
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT DEXTRELL BLISS PHARM D
Provider Business Mailing Address
First Line : 900 49TH ST N
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33710-6625
Country : US
Telephone Number : 727-327-8801
Fax Number : 727-321-4273
Provider Business Practice Location Address
First Line : 900 49TH ST N
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33710-6625
Country : US
Telephone Number : 727-327-8801
Fax Number : 727-321-4273
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2012
Last Update Date : 01/24/2012

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