KENNETH WEBSTER FUQUA SR. (NPI# 1174061048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174061048 |
Entity Type | Individual |
Full Name | KENNETH WEBSTER FUQUA SR. |
Credential | RPH;CPH |
Practice Address |
1122 Old Polk City Rd Lakeland FL 33809-6622 |
Practice Telephone | 8638582828 |
Mailing Telephone | 8638582828 |
Enumeration Date | 2017-02-10 |
Last Update Date | 2017-02-10 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1835G0303X |
Pharmacist Specialization: Geriatric |
PU00102 | FL | Pharmacy Service Providers |
Y | 1835P2201X |
Pharmacist Specialization: Ambulatory Care |
PS11329 | FL | Pharmacy Service Providers |
Street Address |
1122 OLD POLK CITY RD |
City | LAKELAND |
State | FL |
Zip Code | 33809-6622 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861018178 | John C Gallik | Military Health Care Provider | 3176 Corporal Johnson Road, Jbsa Fort Sam Houston, TX 33809 | 2020-06-23 |
1376189209 | Julie Independence Tomchak | Nurse's Aide | 7805 Us Highway Lot 29 # 98 N, Lakeland, FL 33809 | 2019-11-26 |
1912465923 | Lakeland Oaks Nh LLC | Skilled Nursing Facility | 855 Carpenters Way, Lakeland, FL 33809 | 2019-03-08 |
1235528753 | Christia Mccann | Physician Assistant | 4120 Us Hwy. 98 N., One Lakeland Square, Lakeland, FL 33809 | 2015-01-21 |
1548679616 | Ashley Frances Hamarowicz | Physical Therapist | 771 Carpenters Way, Lakeland, FL 33809 | 2014-08-04 |
1750700860 | Grace Manor Suites | Assisted Living Facility | 4620 N Socrum Loop Road, Lakeland, FL 33809 | 2014-04-16 |
1164769980 | Christopher Fisher | Hearing Instrument Specialist | 3800 North Rd 98, Ste 500, Lakeland, FL 33809 | 2013-01-14 |
1023374063 | Eagle Lake Pharmacy Inc | Pharmacy | 5245 A U S Hwy 98 N, Suite A, Lakeland, FL 33809 | 2012-04-04 |
1851669675 | Reginald Keith Jenkins | Pharmacist | 1043 Walt Williams Road, Lakeland, FL 33809 | 2011-12-07 |
1578859633 | Jill Margaret Waldrop | Pharmacist | 6600 N. Socrum Loop, Lakeland, FL 33809 | 2011-06-27 |
Find all providers in zip 33809 |
Taxonomy Code | 1835P2201X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
Specialization | Ambulatory Care |
A licensed pharmacist who has demonstrated specialized knowledge and skill in the provision of integrated, accessible health care services by pharmacists and is accountable for addressing medication needs, developing sustained partnerships with patients, and practicing in the context of family and community. |
Notes: Source: Board of Pharmacy Specialties, www.bpsweb.org [7/1/2015: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689209587 | Tonia Michelle Murray | Pharmacist | 7820 111th Ter E, Parrish, FL 34219-2830 | 2020-03-11 |
1447814785 | Julie Marie Pippins | Pharmacist | 806 Ocean Front, Neptune Beach, FL 32266-6057 | 2019-04-23 |
1326518986 | Donald George Williams Jr. | Pharmacist | 5500 Military Trail, Jupiter, FL 33458 | 2018-11-27 |
1255809943 | Sarah Powers | Pharmacist | 3804 65th Ave E, Sarasota, FL 34243-7923 | 2018-11-12 |
1124595061 | Stefan Correa | Pharmacist | 9498 S.orange Blossom Trl, Orlando, FL 32837-8326 | 2018-10-29 |
1811475130 | Kwame Kyerematen-afrani | Pharmacist | 6266 S Congress Ave Ste L12, Lantana, FL 33462-2365 | 2018-07-30 |
1548773906 | Leslie Alteri | Pharmacist | 1973 Wild Lime Dr, Sanibel, FL 33957-2403 | 2017-11-08 |
1093254708 | Toni Elkach | Pharmacist | 13124 Winfield Scott Blvd, Orlando, FL 32837-4007 | 2017-02-14 |
1619329810 | Curtis Hearn | Pharmacist | 2113 W Lakeview Blvd, N Fort Myers, FL 33903-5813 | 2016-07-12 |
1629437165 | Shameik Brooks | Pharmacist | 655 W 8th St # C-89, Jacksonville, FL 32209-6511 | 2016-02-11 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.