Provider Demographics
NPI:1083999049
Name:PALUCIS, THOMAS ERIC
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ERIC
Last Name:PALUCIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 NE 40TH COURT
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-5456
Mailing Address - Country:US
Mailing Address - Phone:954-560-7376
Mailing Address - Fax:
Practice Address - Street 1:1005 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-7032
Practice Address - Country:US
Practice Address - Phone:954-725-1601
Practice Address - Fax:954-725-4519
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS21421183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist