Individual
JOE SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2330 PALM RIDGE RD STE 12, SANIBEL, FL 33957-3278
(239) 472-6188
(239) 472-6144
Mailing address
10034 RAVELLO BLVD, FORT MYERS, FL 33905-5489
(239) 565-8395
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
RPT75127
FL
Other
Enumeration date
11/21/2018
Last updated
11/21/2018
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