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NPI Code Detail

MEDICARE: MR. MARK VINCENT SANTORO R.PH.

MEDICARE: MR. MARK VINCENT SANTORO R.PH.
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
1183500000XPharmacistPS24408FL

General Provider Information

NPI Number : 1336153212
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARK VINCENT SANTORO R.PH.
Provider Business Mailing Address
First Line : 15151 N DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33618-1818
Country : US
Telephone Number : 813-265-3392
Fax Number :
Provider Business Practice Location Address
First Line : 15151 N DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33618-1818
Country : US
Telephone Number : 813-265-3392
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 03/14/2017

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