MEDICARE: ANTHONY 2016 LLC

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	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PH30196	OTHER	FL	PHARMACY LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881044642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTHONY 2016 LLC

Provider Business Mailing Address
First Line	:	5406 HOOVER BLVD STE 16
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-5330
Country	:	US
Telephone Number	:	813-570-7444
Fax Number	:	813-570-6090

Provider Business Practice Location Address
First Line	:	5406 HOOVER BLVD STE 16
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-5330
Country	:	US
Telephone Number	:	813-570-7444
Fax Number	:	813-570-6090

Authorized Official
Title or Position	:	OWNER
Name	:	MR. KETANKUMAR PATEL
Credential	:	PHARMACIST
Telephone Number	:	813-570-7444

Provider Enumeration Date	:	06/13/2016
Last Update Date	:	01/30/2026

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