Provider Demographics
NPI:1003153685
Name:COMITO, JOSEPH ANTHONY (R PH MS)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:COMITO
Suffix:
Gender:M
Credentials:R PH MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 VILLAGE OAK LN
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4766
Mailing Address - Country:US
Mailing Address - Phone:407-804-1950
Mailing Address - Fax:407-804-1973
Practice Address - Street 1:870 VILLAGE OAK LN
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-4766
Practice Address - Country:US
Practice Address - Phone:407-804-1950
Practice Address - Fax:407-804-1973
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist