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General NPI Number Information
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NPI Number | 1093839318
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Entity Type | Individual
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Provider Name | FREDERIC D EALLONARDO RPH
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Gender | Male
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5300 SE SWEETBRIER TER
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City | HOBE SOUND
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State | FL
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Zip | 33455-7805
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Country | US
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Telephone | 772-781-5354
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1659
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City | HOBE SOUND
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State | FL
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Zip | 33475-1659
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Country | US
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Telephone | 772-781-5354
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS11717
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License Number State | FL
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