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General NPI Number Information
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NPI Number | 1154603355
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Entity Type | Individual
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Provider Name | DWAYNE EDWARD PATE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/13/2011
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Last Update Date | 12/19/2022
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Provider Practice Location Address
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Address Line | 4401 GULF BLVD
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City | ST PETE BEACH
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State | FL
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Zip | 33706-3832
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Country | US
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Telephone | 727-367-7754
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Fax | 727-367-7784
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Provider Business Mailing Address
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Address Line | 9220 LITTLE RD
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City | NEW PORT RICHEY
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State | FL
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Zip | 34654-4222
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Country | US
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Telephone | 727-862-8537
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Fax | 727-367-7784
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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 | PS38955
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License Number State | FL
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