Healthcare Provider Details

I. General information

NPI: 1669383238
Provider Name (Legal Business Name): CLEMENT LACHAT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 W DR MARTIN LUTHER KING JR BLVD
TAMPA FL
33607-6307
US

IV. Provider business mailing address

409 S LOIS AVE
TAMPA FL
33609-3833
US

V. Phone/Fax

Practice location:
  • Phone: 727-820-8200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS71167
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: