Provider Demographics
NPI:1740562156
Name:MAGLIOCCO, JOSEPH P (RPH)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:MAGLIOCCO
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 1:1819 LAUREL OAK DR S
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-3414
Mailing Address - Country:US
Mailing Address - Phone:321-795-4925
Mailing Address - Fax:
Practice Address - Street 1:5475 MURRELL RD
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-6665
Practice Address - Country:US
Practice Address - Phone:321-631-3732
Practice Address - Fax:321-631-7338
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0017275183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist