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NPI Code Detail

MEDICARE: PHYLLIS SLOEZEN COTTINGHAM

MEDICARE: PHYLLIS SLOEZEN COTTINGHAM
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
1183500000XPharmacistPS36371FL

General Provider Information

NPI Number : 1972841559
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHYLLIS SLOEZEN COTTINGHAM
Provider Business Mailing Address
First Line : 3839 PLEASANT HILL RD
Second Line :
City : KISSIMMEE
State : FL
Zip : 34746-2952
Country : US
Telephone Number : 407-343-7878
Fax Number : 407-343-6193
Provider Business Practice Location Address
First Line : 3839 PLEASANT HILL RD
Second Line :
City : KISSIMMEE
State : FL
Zip : 34746-2952
Country : US
Telephone Number : 407-343-7878
Fax Number : 407-343-6193
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2013
Last Update Date : 01/16/2013

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Directions to “ PHYLLIS SLOEZEN COTTINGHAM ” Practice Location

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