Provider Demographics
NPI:1417406497
Name:SICILIANO, WARREN (PHARMD)
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:
Last Name:SICILIANO
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 1:2618 COVE CAY DR
Mailing Address - Street 2:UNIT 208
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-1368
Mailing Address - Country:US
Mailing Address - Phone:727-386-9008
Mailing Address - Fax:
Practice Address - Street 1:2618 COVE CAY DR
Practice Address - Street 2:UNIT 208
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-1368
Practice Address - Country:US
Practice Address - Phone:727-386-9008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-01
Last Update Date:2016-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL27031183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist