Provider Demographics
NPI:1114683927
Name:ROSSI, DINO VICTOR (RPH, AAHIVP)
Entity Type:Individual
Prefix:
First Name:DINO
Middle Name:VICTOR
Last Name:ROSSI
Suffix:
Gender:M
Credentials:RPH, AAHIVP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2716 NE 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33334-1017
Mailing Address - Country:US
Mailing Address - Phone:614-264-9865
Mailing Address - Fax:
Practice Address - Street 1:2608 NE 16TH AVE
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33334-4319
Practice Address - Country:US
Practice Address - Phone:954-932-0691
Practice Address - Fax:954-932-0692
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA038442L183500000X
FLPS46746183500000X
HIPH2625183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacist