Provider Demographics
NPI:1225120611
Name:SWEENEY, PATRICK MARK (RPH)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:MARK
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6514 BLACKFIN WAY
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-3024
Mailing Address - Country:US
Mailing Address - Phone:813-641-0411
Mailing Address - Fax:813-641-0411
Practice Address - Street 1:6188 N US HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-1806
Practice Address - Country:US
Practice Address - Phone:813-649-1304
Practice Address - Fax:813-649-1305
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0023810183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS0023810OtherPHARMACIST LICENSE NUMBER