NPI 1164104113

Mark Edward Wadsworth

Practitioner Pharmacy Technician Englewood, FL

Practice location

Address: 15 S Indiana Ave, Englewood, FL 34223-3305
Phone: (941) 473-7787
Mailing address: 1048 Kansas Ave, Englewood, FL 34223-2527

Registered specialties

Pharmacy Technician Primary

Pharmacy Service Providers Taxonomy 183700000X Licence RPT65160 (FL)

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Registry record

NPI: 1164104113
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Aug 2023
Record last updated: 1 Aug 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.