Provider Demographics
NPI:1720190168
Name:EYLER, MARK
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:EYLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 W THARPE ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-4664
Mailing Address - Country:US
Mailing Address - Phone:850-297-2557
Mailing Address - Fax:850-297-2560
Practice Address - Street 1:1625 W THARPE ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-4664
Practice Address - Country:US
Practice Address - Phone:850-297-2557
Practice Address - Fax:850-297-2560
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS32984183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0556050928Medicare ID - Type Unspecified