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General NPI Number Information
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NPI Number | 1336205459
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Entity Type | Individual
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Provider Name | RAYMOND A. DADALT R.PH., M.P.H., J.D.
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Gender | Male
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Dates
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Enumeration Date | 01/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2778 N ROOSEVELT BLVD
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City | KEY WEST
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State | FL
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Zip | 33040-3930
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Country | US
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Telephone | 305-294-0658
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 ATLANTIC BLVD APT C324
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City | KEY WEST
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State | FL
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Zip | 33040-5379
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Country | US
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Telephone | 305-294-0658
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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 | PS36511
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License Number State | FL
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