CARL D ACQUAVIVA NPI 1780970673

NPI Information

  • NPI: 1780970673
  • Provider Name: CARL D ACQUAVIVA
  • Classification: Pharmacy - 3336L0003X
  • Specialization: Long Term Care Pharmacy
  • Entity Type: Organization
  • Doing Business As: ACQUAVIVA'S LTC PHARMACY
  • CLIA Number: 10D0950915
  • Address: 1555 PORT MALABAR BLVD NE STE 102B
    PALM BAY, FL
    ZIP 32905
  • Phone: (321) 725-7188

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NPI Details

CARL D ACQUAVIVA is a long term care pharmacy pharmacy in Palm Bay, FL. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. CARL D ACQUAVIVA NPI is 1780970673. The provider is registered as an organization entity type.
The provider Is Doing Business As Acquaviva's Ltc Pharmacy.

The provider's business location address is:

1555 PORT MALABAR BLVD NE STE 102B
PALM BAY, FL
ZIP 32905-407
Phone: (321) 725-7188
Fax: (321) 728-1333

The provider's authorized official is Carl Acquaviva .
The authorized official title is Pharmacy Dept Manager and has the following contact phone number (321) 768-1400.

The CLIA number assigned to this NPI record is 10D0950915 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/20/2011 and was last updated on 2/5/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyPH25270FLORIDANo
23336L0003XPharmacyLong Term Care PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12131033OTHERPK
2104293900MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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