Individual
MARK EDWARD WADSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15 S INDIANA AVE, ENGLEWOOD, FL 34223-3305
(941) 473-7787
Mailing address
1048 KANSAS AVE, ENGLEWOOD, FL 34223-2527
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
RPT65160
FL
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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