Provider Demographics
NPI:1265709604
Name:CONLON, DEBORAH LYNN (BS PHARM, PHARMD)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYNN
Last Name:CONLON
Suffix:
Gender:F
Credentials:BS PHARM, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 W LEMON ST
Mailing Address - Street 2:SUITE 311
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-1111
Mailing Address - Country:US
Mailing Address - Phone:813-367-2254
Mailing Address - Fax:813-769-1881
Practice Address - Street 1:5100 W LEMON ST
Practice Address - Street 2:SUITE 311
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-1111
Practice Address - Country:US
Practice Address - Phone:813-367-2254
Practice Address - Fax:813-769-1881
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS00225991835P0018X
MI53020260991835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist