Provider Demographics
NPI:1467676502
Name:FILOSI, MARK VINCENT (RPH)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:VINCENT
Last Name:FILOSI
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 1:5732 EAGLEMOUNT CIR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-3840
Mailing Address - Country:US
Mailing Address - Phone:813-685-2031
Mailing Address - Fax:
Practice Address - Street 1:1505 W REYNOLDS ST
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-4733
Practice Address - Country:US
Practice Address - Phone:813-659-9777
Practice Address - Fax:813-659-1485
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL28880183500000X
MA21652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist