Healthcare Provider Details

I. General information

NPI: 1598779365
Provider Name (Legal Business Name): ERIC TAWNEY R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1065 NE 125TH ST STE 207
NORTH MIAMI FL
33161-5832
US

IV. Provider business mailing address

1065 NE 125TH ST STE 207
NORTH MIAMI FL
33161-5832
US

V. Phone/Fax

Practice location:
  • Phone: 863-470-3657
  • Fax: 786-347-0321
Mailing address:
  • Phone: 786-347-0365
  • Fax: 786-347-0321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-2-18193
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302026406
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPS61714
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: