Individual
DOUGLAS FASNACHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
22920 STATE ROAD 54, LUTZ, FL 33549-6931
(813) 949-7872
(813) 949-6690
Mailing address
22920 STATE ROAD 54, LUTZ, FL 33549-6931
(813) 949-7872
(813) 949-6690
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
39620
FL
Other
Enumeration date
08/13/2009
Last updated
11/17/2010
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