Amy Crake
Individual provider Active NPI Pharmacist · Lutz, FL
NPI 1275924953 · NPPES record last updated Feb 17, 2015
Key facts
- NPI
- 1275924953
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 23057 (FL)
- Practice address
- 1040 Dale Mabry Hwy
Lutz, FL 33548-3004 - Phone
- (813) 435-2934
- NPI assigned
- Feb 17, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23057 | FL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 23057 | FL | Yes |
Addresses
Primary practice location
1040 Dale Mabry Hwy
Lutz, FL 33548-3004
Mailing address
5610 Piney Lane Dr
Tampa, FL 33625-4042
Phone (813) 960-2608
Other names
- Amy Gardner
Other providers in Lutz, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.