Healthcare Provider Details

I. General information

NPI: 1174837306
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL DITOMASO PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 07/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER ROAD (119)
GAINESVILLE FL
32608
US

IV. Provider business mailing address

1601 SW ARCHER ROAD (119)
GAINESVILLE FL
32608
US

V. Phone/Fax

Practice location:
  • Phone: 352-374-6062
  • Fax:
Mailing address:
  • Phone: 352-374-6062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: