Provider Demographics
NPI:1912344177
Name:MOBLEY, ANDREW O (RPH)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:O
Last Name:MOBLEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 11454
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33680
Mailing Address - Country:US
Mailing Address - Phone:813-598-9138
Mailing Address - Fax:813-914-8837
Practice Address - Street 1:4424 TUNA DRIVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617
Practice Address - Country:US
Practice Address - Phone:813-598-9138
Practice Address - Fax:813-914-8837
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0016902183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist