Provider Demographics
NPI:1710225370
Name:HOUTZ, JOSHUA (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:HOUTZ
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 1:3106 SEAWAY CT
Mailing Address - Street 2:APT 202
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-1700
Mailing Address - Country:US
Mailing Address - Phone:785-443-2904
Mailing Address - Fax:
Practice Address - Street 1:1313 S DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5010
Practice Address - Country:US
Practice Address - Phone:813-258-9301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48432183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist