Provider Demographics
NPI:1861744427
Name:CASELLA, SEAN STEVEN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:STEVEN
Last Name:CASELLA
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 1:6285 E FOWLER AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-3304
Mailing Address - Country:US
Mailing Address - Phone:813-983-1500
Mailing Address - Fax:813-983-1501
Practice Address - Street 1:6285 E FOWLER AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-3304
Practice Address - Country:US
Practice Address - Phone:813-983-1500
Practice Address - Fax:813-983-1501
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49927183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist