Sistiva Maureen Travis
Pharmacy Technician in Port St Lucie, FL. Individual provider (NPI-1).
NPI number1306449103
StatusActive
Last updated in NPPESNov 16, 2020
Details
- NPI
- 1306449103
- Entity type
- Individual (NPI-1)
- Name
- Sistiva Maureen Travis
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 16, 2020
- Certification date
- Nov 16, 2020
- Last updated
- Nov 16, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183700000X | Pharmacy Technician | 260101030760092 | FL | Yes |
Practice location
10000 Sw Innovation WayPort St Lucie, FL 34987-2111
Phone 772-223-5945
Mailing address
4281 Sw Tuscol StPort St Lucie, FL 34953-6814
Phone 772-807-1662
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