MEDICARE: ELENI BILLIRIS DELMADOROS PHARMD

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
1	183500000X	Pharmacist	PS44038	FL

General Provider Information

NPI Number	:	1740528058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELENI BILLIRIS DELMADOROS PHARMD

Provider Business Mailing Address
First Line	:	1025 WIDEVIEW AVE
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34689-2141
Country	:	US
Telephone Number	:	727-940-5531
Fax Number	:

Provider Business Practice Location Address
First Line	:	40932 US HIGHWAY 19 N
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34689-5446
Country	:	US
Telephone Number	:	727-938-3760
Fax Number	:	727-943-8958

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2013
Last Update Date	:	01/21/2013

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