MEDICARE: STEPHEN DILLON PHARMD

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	60902	FL

General Provider Information

NPI Number	:	1932727336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN DILLON PHARMD

Provider Business Mailing Address
First Line	:	17179 TAMIAMI TRL
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34287-7291
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17179 TAMIAMI TRL
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34287-7291
Country	:	US
Telephone Number	:	941-426-8577
Fax Number	:

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

Provider Enumeration Date	:	07/12/2020
Last Update Date	:	07/13/2020

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