Provider Demographics
NPI:1881148047
Name:MEOLA, PAUL (PHARMD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:MEOLA
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 1:7733 JUSTIN CT N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-1249
Mailing Address - Country:US
Mailing Address - Phone:727-459-4561
Mailing Address - Fax:
Practice Address - Street 1:1013 WOODBRIDGE CENTER WAY
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-3836
Practice Address - Country:US
Practice Address - Phone:410-676-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist