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NPI 1174658082

NPI 1174658082 : ROBERT L PELOT RPH : BRADENTON, FL

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General NPI Number Information
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    NPI Number           |    1174658082
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERT L PELOT RPH
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/22/2007
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    Last Update Date     |    01/25/2022
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Provider Practice Location Address
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    Address Line         |    831 MANATEE AVE E 
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    City                 |    BRADENTON
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    State                |    FL
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    Zip                  |    34208-1243
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    Country              |    US
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    Telephone            |    941-748-8130
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    Fax                  |    941-749-5406
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Provider Business Mailing Address
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    Address Line         |    831 MANATEE AVE E 
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    City                 |    BRADENTON
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    State                |    FL
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    Zip                  |    34208-1243
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    Country              |    US
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    Telephone            |    941-748-8130
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    Fax                  |    941-749-5406
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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       |    PS0012705
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    License Number State |    FL
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Taxonomy #2
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    Taxonomy Code        |    3336C0003X
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    Taxonomy Name        |    Community/Retail Pharmacy
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    License Number       |    PH2470
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    License Number State |    FL
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