Provider Demographics
NPI:1730723966
Name:ADAMO, ANTHONY ALEXANDER JR (RPH)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:ALEXANDER
Last Name:ADAMO
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13803 NIGHTHAWK TER
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-6347
Mailing Address - Country:US
Mailing Address - Phone:941-276-2299
Mailing Address - Fax:
Practice Address - Street 1:5315 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-2814
Practice Address - Country:US
Practice Address - Phone:941-795-1807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-31
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS33136183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist