Provider Demographics
NPI:1174510754
Name:DETONE, MELANIE PEGGY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:PEGGY
Last Name:DETONE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:MELANIE
Other - Middle Name:PEGGY
Other - Last Name:BILZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3601 105TH AVE N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-5450
Mailing Address - Country:US
Mailing Address - Phone:727-540-9242
Mailing Address - Fax:
Practice Address - Street 1:10000 BAY PINES BLVD
Practice Address - Street 2:
Practice Address - City:BAY PINES
Practice Address - State:FL
Practice Address - Zip Code:33744-5001
Practice Address - Country:US
Practice Address - Phone:727-398-6661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2007-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 371121835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy