Provider Demographics
NPI:1710193248
Name:LALLONE, PETER JAMES (RPH)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:JAMES
Last Name:LALLONE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 SE 21ST TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-4662
Mailing Address - Country:US
Mailing Address - Phone:239-560-6784
Mailing Address - Fax:
Practice Address - Street 1:27680 BERMONT RD.
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33982
Practice Address - Country:US
Practice Address - Phone:941-505-9583
Practice Address - Fax:941-505-9657
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0025533183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist