Healthcare Provider Details

I. General information

NPI: 1225940018
Provider Name (Legal Business Name): ANDREW ATTALLA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2268 COBB DR
TALLAHASSEE FL
32312-3170
US

IV. Provider business mailing address

2268 COBB DR
TALLAHASSEE FL
32312-3170
US

V. Phone/Fax

Practice location:
  • Phone: 850-321-4933
  • Fax:
Mailing address:
  • Phone: 850-321-4933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS70593
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: