Derek Eugene Dixon, PHARMD
Individual provider Active NPI Pharmacist · Mulberry, FL
NPI 1316190481 · NPPES record last updated Nov 2, 2008
Key facts
- NPI
- 1316190481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PS38892 (FL)
- Practice address
- 3666 Starburst CT
Mulberry, FL 33860-8526 - Phone
- (863) 581-9308
- NPI assigned
- Nov 2, 2008
- Sex
- Male
- 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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS38892 | FL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS38892 | FL | Yes |
Addresses
Primary practice location
3666 Starburst CT
Mulberry, FL 33860-8526
Mailing address
3666 Starburst CT
Mulberry, FL 33860-8526
Phone (863) 581-9308
Other providers in Mulberry, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2008. 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.