Provider Demographics
NPI:1093084667
Name:TOLAN, SUNITA (PHARMD)
Entity Type:Individual
Prefix:
First Name:SUNITA
Middle Name:
Last Name:TOLAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2769 INLET COVE LN W
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-7548
Mailing Address - Country:US
Mailing Address - Phone:954-494-8405
Mailing Address - Fax:
Practice Address - Street 1:15295 COLLIER BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-7715
Practice Address - Country:US
Practice Address - Phone:239-352-7354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42861183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist