Provider Demographics
NPI:1912591850
Name:TOSELLI, SANDRA MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:SANDRA MARIE
Middle Name:
Last Name:TOSELLI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12084 LAKE ALLEN DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-2929
Mailing Address - Country:US
Mailing Address - Phone:727-798-7216
Mailing Address - Fax:
Practice Address - Street 1:9020 ULMERTON RD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-3820
Practice Address - Country:US
Practice Address - Phone:727-431-5016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31908183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist