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General NPI Number Information
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NPI Number | 1699099176
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Entity Type | Individual
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Provider Name | THOMAS LAWSON DILDINE JR. PHARM D
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Gender | Male
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Dates
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Enumeration Date | 03/26/2010
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Last Update Date | 06/25/2018
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Provider Practice Location Address
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Address Line | 124 NE 5TH AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33483
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Country | US
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Telephone | 561-272-2124
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Fax | 561-272-2830
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Provider Business Mailing Address
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Address Line | 124 NE 5TH AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33483-5429
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Country | US
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Telephone | 561-272-2124
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Fax | 561-272-2830
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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 | PS40271
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License Number State | FL
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