Healthcare Provider Details

I. General information

NPI: 1174658082
Provider Name (Legal Business Name): ROBERT L PELOT RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 MANATEE AVE E
BRADENTON FL
34208-1243
US

IV. Provider business mailing address

831 MANATEE AVE E
BRADENTON FL
34208-1243
US

V. Phone/Fax

Practice location:
  • Phone: 941-748-8130
  • Fax: 941-749-5406
Mailing address:
  • Phone: 941-748-8130
  • Fax: 941-749-5406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS12705
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH2470
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: