Organization
CARL D ACQUAVIVA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL D ACQUAVIVA RPH (PHARMACIST OWNER)
(321) 725-7188
Entity
Organization
Contact information
Practice address
1555 PORT MALABAR BLVD NE, SUITE 101, PALM BAY, FL 32905-5407
(321) 725-7188
(321) 728-1333
Mailing address
1555 PORT MALABAR BLVD NE, SUITE 101, PALM BAY, FL 32905-5407
(321) 725-7188
(321) 728-1333
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH10316
FL
Other
Enumeration date
12/02/2008
Last updated
12/18/2008
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