Provider Demographics
NPI:1669739652
Name:TOMCZAK, ERIC LEONARD (PHARMD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:LEONARD
Last Name:TOMCZAK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2865 NE 34TH ST
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-8555
Mailing Address - Country:US
Mailing Address - Phone:954-270-9371
Mailing Address - Fax:
Practice Address - Street 1:3890 PARK CENTRAL BLVD N
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-2264
Practice Address - Country:US
Practice Address - Phone:954-633-4252
Practice Address - Fax:888-443-5034
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-16
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0034450183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No183500000XPharmacy Service ProvidersPharmacist