Provider Demographics
NPI:1295076842
Name:MARCANTONIO, JAMES (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MARCANTONIO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 NE 27TH TER
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-4225
Mailing Address - Country:US
Mailing Address - Phone:954-410-0306
Mailing Address - Fax:
Practice Address - Street 1:1041 NE 27TH TER
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-4225
Practice Address - Country:US
Practice Address - Phone:954-410-0306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0020352183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist