Provider Demographics
NPI:1982205886
Name:TOUT, TIMOTHY S (PHARMD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:S
Last Name:TOUT
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 1:13300 CORTEZ BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34613-4887
Mailing Address - Country:US
Mailing Address - Phone:352-596-0797
Mailing Address - Fax:352-596-8451
Practice Address - Street 1:13300 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-4887
Practice Address - Country:US
Practice Address - Phone:352-596-0797
Practice Address - Fax:352-596-8451
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41850183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist