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General NPI Number Information
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NPI Number | 1194098467
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Entity Type | Individual
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Provider Name | DENNIS MICHAEL VANDYKE RPH
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Gender | Male
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Dates
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Enumeration Date | 02/17/2012
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Last Update Date | 02/17/2012
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Provider Practice Location Address
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Address Line | 1201 S OCEAN BLVD SUITE 14
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City | POMPANO BEACH
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State | FL
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Zip | 33062-6668
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Country | US
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Telephone | 954-942-1866
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Fax | 866-709-4405
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Provider Business Mailing Address
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Address Line | 1201 S OCEAN BLVD SUITE 14
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City | POMPANO BEACH
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State | FL
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Zip | 33062-6668
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Country | US
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Telephone | 954-942-1866
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Fax | 866-709-4405
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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 | 24195
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License Number State | FL
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