Provider Demographics
NPI:1558632455
Name:PUTZE, MICHAEL K (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:K
Last Name:PUTZE
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 1:1501 PASADENA AVE S
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:FL
Mailing Address - Zip Code:33707-3717
Mailing Address - Country:US
Mailing Address - Phone:412-716-3457
Mailing Address - Fax:
Practice Address - Street 1:1501 PASADENA AVE S
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-3717
Practice Address - Country:US
Practice Address - Phone:412-716-3457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 38330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist