Provider Demographics
NPI:1891879078
Name:TOMAKA, NORMAN PAUL (MS PHARM, CPH, LHRM)
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:PAUL
Last Name:TOMAKA
Suffix:
Gender:M
Credentials:MS PHARM, CPH, LHRM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 OAK ST
Mailing Address - Street 2:HEALTH FIRST
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3178
Mailing Address - Country:US
Mailing Address - Phone:321-434-7255
Mailing Address - Fax:321-434-1950
Practice Address - Street 1:1305 OAK ST
Practice Address - Street 2:HEALTH FIRST
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3178
Practice Address - Country:US
Practice Address - Phone:321-434-7255
Practice Address - Fax:321-434-1950
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS018594183500000X
FLPU34691835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS18594OtherREGISTERED IMMUNIZING PHARMACIST
FLPU03469OtherCONSULTANT PHARMACIST