Provider Demographics
NPI:1245744887
Name:MCCLINTON, CONNOR PATRICK (PHARM D)
Entity Type:Individual
Prefix:
First Name:CONNOR
Middle Name:PATRICK
Last Name:MCCLINTON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1890 S UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-5808
Mailing Address - Country:US
Mailing Address - Phone:954-236-7837
Mailing Address - Fax:954-236-7846
Practice Address - Street 1:1890 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324-5808
Practice Address - Country:US
Practice Address - Phone:954-236-7837
Practice Address - Fax:954-236-7846
Is Sole Proprietor?:No
Enumeration Date:2017-11-17
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS57334183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist