Provider Demographics
NPI:1720680085
Name:LAPORTA, VICTOR ANTHONY (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:ANTHONY
Last Name:LAPORTA
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 10TH ST E
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-4062
Mailing Address - Country:US
Mailing Address - Phone:941-723-2677
Mailing Address - Fax:941-723-2844
Practice Address - Street 1:508 10TH ST E
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-4062
Practice Address - Country:US
Practice Address - Phone:941-723-2677
Practice Address - Fax:941-723-2844
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS18424183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist