Healthcare Provider Details

I. General information

NPI: 1538432422
Provider Name (Legal Business Name): PAULINE ANNA DCHIUTIIS RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2012
Last Update Date: 02/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 PLAZA REAL SUITE P 205
BOCA RATON FL
33432-3953
US

IV. Provider business mailing address

320 PLAZA REAL SUITE P 205
BOCA RATON FL
33432
US

V. Phone/Fax

Practice location:
  • Phone: 561-447-4422
  • Fax:
Mailing address:
  • Phone: 561-447-4422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number037747-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: