Provider Demographics
NPI:1801181847
Name:PULLO, JOSHUA RANDALL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:RANDALL
Last Name:PULLO
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 1:325 N ALAFAYA TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7012
Mailing Address - Country:US
Mailing Address - Phone:407-482-8194
Mailing Address - Fax:407-482-8194
Practice Address - Street 1:325 N ALAFAYA TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7012
Practice Address - Country:US
Practice Address - Phone:407-482-8194
Practice Address - Fax:407-482-8194
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS46212183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist