Provider Demographics
NPI:1730416744
Name:RAPAPORT, RONALD RALPH (RPH, CPH)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:RALPH
Last Name:RAPAPORT
Suffix:
Gender:M
Credentials:RPH, CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 COASTAL OAK CIR
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-2700
Mailing Address - Country:US
Mailing Address - Phone:904-285-0079
Mailing Address - Fax:904-273-6575
Practice Address - Street 1:130 COASTAL OAK CIR
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-2700
Practice Address - Country:US
Practice Address - Phone:904-285-0079
Practice Address - Fax:904-273-6575
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS13330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist