Provider Demographics
NPI:1548423668
Name:PUSTINGER, DENNIS M (BS PHARM)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:M
Last Name:PUSTINGER
Suffix:
Gender:M
Credentials:BS PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 INTERNATIONAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8261
Mailing Address - Country:US
Mailing Address - Phone:407-345-8402
Mailing Address - Fax:407-345-4844
Practice Address - Street 1:6201 INTERNATIONAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8261
Practice Address - Country:US
Practice Address - Phone:407-345-8402
Practice Address - Fax:407-345-4844
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS31002183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist