Provider Demographics
NPI:1114522117
Name:PUSCH, BARBARA ANGELA
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANGELA
Last Name:PUSCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5795 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5315
Mailing Address - Country:US
Mailing Address - Phone:305-299-8339
Mailing Address - Fax:
Practice Address - Street 1:5795 SUNSET DR
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5315
Practice Address - Country:US
Practice Address - Phone:305-666-1085
Practice Address - Fax:305-666-6237
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS29789183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist