Provider Demographics
NPI:1184051369
Name:MACDONALD, ADAM J (PHARMD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:J
Last Name:MACDONALD
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 1:10144 ARBOR RUN DR UNIT 61
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3568
Mailing Address - Country:US
Mailing Address - Phone:207-776-8211
Mailing Address - Fax:
Practice Address - Street 1:20741 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2913
Practice Address - Country:US
Practice Address - Phone:813-907-0878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS51244183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist