Mark Gerstle, RPH
Individual provider Active NPI Pharmacist · Mims, FL
NPI 1457636367 · NPPES record last updated Oct 12, 2011
Key facts
- NPI
- 1457636367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PS0021659 (FL)
- Practice address
- 2475 N US 1
Mims, FL 32754-3874 - Phone
- (321) 267-1788
- Fax
- (321) 267-3044
- NPI assigned
- Oct 12, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS0021659 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS0021659 | FL | Yes |
Addresses
Primary practice location
2475 N US 1
Mims, FL 32754-3874
Mailing address
2475 N US 1
Mims, FL 32754-3874
Phone (321) 267-1788
Other providers in Mims, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2011. 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.