Provider Demographics
NPI:1669552360
Name:TUMA, PAUL EDWARD
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:EDWARD
Last Name:TUMA
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 1:392 EPPINGER DRIVE
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33953
Mailing Address - Country:US
Mailing Address - Phone:941-743-0817
Mailing Address - Fax:
Practice Address - Street 1:2000 KINGS HIGHWAY
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33983
Practice Address - Country:US
Practice Address - Phone:941-629-1512
Practice Address - Fax:941-629-7091
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS18915183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0556050512Medicare ID - Type Unspecified