Provider Demographics
NPI:1235424995
Name:SIVON, JOHN MICHAEL JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:MICHAEL
Last Name:SIVON
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3101 AERIAL WAY
Mailing Address - Street 2:T-2489
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34604-0629
Mailing Address - Country:US
Mailing Address - Phone:352-593-2169
Mailing Address - Fax:352-593-2169
Practice Address - Street 1:3101 AERIAL WAY
Practice Address - Street 2:T-2489
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34604-0629
Practice Address - Country:US
Practice Address - Phone:352-593-2169
Practice Address - Fax:352-593-2169
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0033663183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist