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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KENNETH WEBSTER FUQUA SR., RPH;CPH

Active Sole Proprietor

Ambulatory Care Pharmacist · LAKELAND, FL

Registration Details

NPI Number
1174061048
Provider Type
Individual
Gender
Male
NPI Issued
Feb 10, 2017 (9.1938107907358 yrs)
Last Updated
Feb 10, 2017
Licenses
PU00102 (FL)
PS11329 (FL)
Sole Proprietor
Yes

Practice Information

Address
1122 OLD POLK CITY RD
LAKELAND, FL, 338096622
Browse FL providers · Browse ZIP 33809
Phone
8638582828
Primary Specialty
Ambulatory Care Pharmacist
1835P2201X
Additional Specialty
Ambulatory Care Pharmacist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.