Provider Demographics
NPI:1093705253
Name:DALLMAN, JANET LEA (CPH)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LEA
Last Name:DALLMAN
Suffix:
Gender:F
Credentials:CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6106 55TH TER E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-9762
Mailing Address - Country:US
Mailing Address - Phone:941-758-7688
Mailing Address - Fax:941-758-7688
Practice Address - Street 1:6106 55TH TER E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-9762
Practice Address - Country:US
Practice Address - Phone:941-758-7688
Practice Address - Fax:941-758-7688
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPU43821835G0303X
FLPS29198183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1835G0303XPharmacy Service ProvidersPharmacistGeriatric
Not Answered183500000XPharmacy Service ProvidersPharmacist