Healthcare Provider Details

I. General information

NPI: 1427104587
Provider Name (Legal Business Name): ANTHONY MEOLA RPH.,CPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5816 N UNIVERSITY DR
TAMARAC FL
33321-4634
US

IV. Provider business mailing address

7641 NW 13TH CT
PLANTATION FL
33322-4705
US

V. Phone/Fax

Practice location:
  • Phone: 954-726-1911
  • Fax: 954-726-7023
Mailing address:
  • Phone: 954-370-6684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS22173
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: