Efrain A Delvalle, PHARMACIST
Individual provider Active NPI Pharmacist · Patrick Afb, FL
NPI 1508927237 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1508927237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 003803 (PR)
- Practice address
- 1381 S Patrick Drive
45TH Medical Group
Patrick Afb, FL 32925 - Phone
- (321) 494-9313
- Fax
- (321) 494-7997
- NPI assigned
- Dec 13, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| 003803 | PR | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 003803 | PR | Yes |
Addresses
Primary practice location
1381 S Patrick Drive
45TH Medical Group
Patrick Afb, FL 32925
Mailing address
1381 S Patrick Drive
45TH Medical Group
Patrick Afb, FL 32925
Phone (321) 494-9313
Other providers in Patrick Afb, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.