MEDICARE: DR. THOMAS ROSS ISBON PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	37988	FL

General Provider Information

NPI Number	:	1336418615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS ROSS ISBON PHARM.D.

Provider Business Mailing Address
First Line	:	2760 S FALKENBURG RD
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33578-2561
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2760 S FALKENBURG RD
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33578-2561
Country	:	US
Telephone Number	:	813-621-6041
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2011
Last Update Date	:	12/15/2011

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