Provider Demographics
NPI:1649944232
Name:ALLEAVITCH, ROBERT ABRAHAM (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ABRAHAM
Last Name:ALLEAVITCH
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 1:7837 VIA GRANDE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-7518
Mailing Address - Country:US
Mailing Address - Phone:954-336-5941
Mailing Address - Fax:
Practice Address - Street 1:7837 VIA GRANDE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-7518
Practice Address - Country:US
Practice Address - Phone:954-336-5941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS17178183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist