Provider Demographics
NPI:1154052546
Name:MUGAVERO, VALERIE GAIL (RPH)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:GAIL
Last Name:MUGAVERO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:GAIL
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8715 HENDERSON RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-1143
Mailing Address - Country:US
Mailing Address - Phone:813-206-4193
Mailing Address - Fax:
Practice Address - Street 1:8715 HENDERSON RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-1143
Practice Address - Country:US
Practice Address - Phone:813-206-4193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS24218183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist