Provider Demographics
NPI:1841076775
Name:DAPELLO, JAMES ANDREW
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ANDREW
Last Name:DAPELLO
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 1:1595 LUDINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-7612
Mailing Address - Country:US
Mailing Address - Phone:941-524-2421
Mailing Address - Fax:
Practice Address - Street 1:30841 MIRADA BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:FL
Practice Address - Zip Code:33576-7305
Practice Address - Country:US
Practice Address - Phone:352-588-1199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS66275183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist