Provider Demographics
NPI:1518182971
Name:GATTOLINE, JOHN J JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:J
Last Name:GATTOLINE
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11502 TULLAMORE ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-2455
Mailing Address - Country:US
Mailing Address - Phone:813-988-6797
Mailing Address - Fax:813-899-4999
Practice Address - Street 1:1615 SUN CITY CENTER PLZ
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5385
Practice Address - Country:US
Practice Address - Phone:813-634-1729
Practice Address - Fax:813-899-4999
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist