Provider Demographics
NPI:1518205954
Name:DAGESSE, BARBARA JEAN (RPH)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JEAN
Last Name:DAGESSE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4421 PARK BLVD N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3540
Mailing Address - Country:US
Mailing Address - Phone:727-239-4529
Mailing Address - Fax:727-827-2809
Practice Address - Street 1:4421 PARK BLVD N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3540
Practice Address - Country:US
Practice Address - Phone:727-239-4529
Practice Address - Fax:727-827-2809
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS21000183500000X
VT033.0003095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist