Healthcare Provider Details

I. General information

NPI: 1497872378
Provider Name (Legal Business Name): MARY ANN GIANDONATO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 TALL PINES DR SUITE 118
LARGO FL
33771-5341
US

IV. Provider business mailing address

18305 PARRISH GROVE RD
DADE CITY FL
33523-6586
US

V. Phone/Fax

Practice location:
  • Phone: 727-524-9333
  • Fax:
Mailing address:
  • Phone: 352-521-9729
  • Fax: 352-521-9729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS35019
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: