Provider Demographics
NPI:1417125857
Name:THRESS, DALE B (RPH)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:B
Last Name:THRESS
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 1:2778 N ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-3930
Mailing Address - Country:US
Mailing Address - Phone:305-294-0658
Mailing Address - Fax:305-294-6378
Practice Address - Street 1:2778 N ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-3930
Practice Address - Country:US
Practice Address - Phone:305-294-0658
Practice Address - Fax:305-294-6378
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0024689183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY034616OtherNY LICENSE
FLPS0024689OtherFL LICENSE