Provider Demographics
NPI:1356065437
Name:CARROTHERS, CAMERON TODD
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:TODD
Last Name:CARROTHERS
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 1:32765 EILAND BLVD
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33545-5268
Mailing Address - Country:US
Mailing Address - Phone:813-779-2510
Mailing Address - Fax:813-779-2814
Practice Address - Street 1:32765 EILAND BLVD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33545-5268
Practice Address - Country:US
Practice Address - Phone:813-779-2510
Practice Address - Fax:813-779-2814
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS64771183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist