Provider Demographics
NPI:1356688931
Name:SANOW, DANIEL LARRY (RPH)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:LARRY
Last Name:SANOW
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 1:6760 W GULF TO LAKE HWY
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34429-9348
Mailing Address - Country:US
Mailing Address - Phone:352-795-5393
Mailing Address - Fax:352-795-4341
Practice Address - Street 1:6760 W GULF TO LAKE HWY
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-9348
Practice Address - Country:US
Practice Address - Phone:352-795-5393
Practice Address - Fax:352-795-4341
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS27015183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist