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NPI Code Detail

MEDICARE: MRS. DIANE MARIE TOLOSKY RPH

MEDICARE: MRS. DIANE MARIE TOLOSKY RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS21495FL

General Provider Information

NPI Number : 1275814303
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DIANE MARIE TOLOSKY RPH
Provider Business Mailing Address
First Line : 7129 HANSON DR N
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32210-1212
Country : US
Telephone Number : 904-781-6373
Fax Number :
Provider Business Practice Location Address
First Line : 1305 N ORANGE AVE STE 120-123
Second Line :
City : GREEN COVE SPRINGS
State : FL
Zip : 32043-2547
Country : US
Telephone Number : 904-284-5677
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2011
Last Update Date : 09/07/2016

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Directions to “ MRS. DIANE MARIE TOLOSKY RPH” Practice Location

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