Provider Demographics
NPI:1376219998
Name:PAPANTONIOU, EUGENE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:
Last Name:PAPANTONIOU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 TECH BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-7862
Mailing Address - Country:US
Mailing Address - Phone:813-551-1165
Mailing Address - Fax:
Practice Address - Street 1:1209 TECH BLVD STE 102
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-7862
Practice Address - Country:US
Practice Address - Phone:813-551-1165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49221183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist