Provider Demographics
NPI:1861265415
Name:HART, THOMAS GUY (PHARMD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:GUY
Last Name:HART
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2873 VIA NAPOLI
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-8631
Mailing Address - Country:US
Mailing Address - Phone:305-509-9391
Mailing Address - Fax:
Practice Address - Street 1:6651 N MILITARY TRL STE 201
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2402
Practice Address - Country:US
Practice Address - Phone:401-665-5634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41516183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist