Provider Demographics
NPI:1891065736
Name:MCDONALD, ALEX III (PHRAMD)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:
Last Name:MCDONALD
Suffix:III
Gender:M
Credentials:PHRAMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 E HILLSBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-8204
Mailing Address - Country:US
Mailing Address - Phone:813-237-3743
Mailing Address - Fax:813-239-9314
Practice Address - Street 1:2115 E HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-8204
Practice Address - Country:US
Practice Address - Phone:813-237-3743
Practice Address - Fax:813-239-9314
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43090183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist