Basic Information
| Provider Information | |||||||||
| NPI: | 1023005741 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAPUTI | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | VIRGINIA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2237 PINELAND DR | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342236332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9412352710 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 21281 GRAYTON TER | ||||||||
| Address2: | DOUGLAS T. JACOBSON STATE VETERANS NURSING HOME | ||||||||
| City: | PORT CHARLOTTE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339543109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9412352710 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P1200X | PS 21984 | FL | Y | Pharmacy Service Providers | Pharmacist | Pharmacotherapy |
No ID Information.