Healthcare Provider Details

I. General information

NPI: 1093092728
Provider Name (Legal Business Name): ANTHONY ZAPICO RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2011
Last Update Date: 11/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 GRANDVIEW PKWY T-2366
DAVENPORT FL
33837-2300
US

IV. Provider business mailing address

5000 GRANDVIEW PKWY T-2366
DAVENPORT FL
33837-2300
US

V. Phone/Fax

Practice location:
  • Phone: 863-256-1052
  • Fax: 863-256-1052
Mailing address:
  • Phone: 863-256-1052
  • Fax: 863-256-1052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS39965
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: