Provider Demographics
NPI:1922345974
Name:DELOSSANTOS, PAUL JAMES
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JAMES
Last Name:DELOSSANTOS
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 1:10411 ULMERTON RD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-3530
Mailing Address - Country:US
Mailing Address - Phone:727-588-1291
Mailing Address - Fax:
Practice Address - Street 1:10411 ULMERTON RD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-3530
Practice Address - Country:US
Practice Address - Phone:727-588-1291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43928183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist