Provider Demographics
NPI:1598739096
Name:VAGNINI, THOMAS J (RPH, DPH)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:VAGNINI
Suffix:
Gender:M
Credentials:RPH, DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 JAGUAR CT
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-3720
Mailing Address - Country:US
Mailing Address - Phone:407-699-7137
Mailing Address - Fax:
Practice Address - Street 1:1214 JAGUAR CT
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-3720
Practice Address - Country:US
Practice Address - Phone:407-699-7137
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0015543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist