Provider Demographics
NPI:1952666208
Name:CIFELLI, MARK CATLETT (PHARMD, BCPS, BCACP)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:CATLETT
Last Name:CIFELLI
Suffix:
Gender:M
Credentials:PHARMD, BCPS, BCACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 AIRPORT RD APT 1223
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-2818
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:955 AIRPORT RD APT 512
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-2829
Practice Address - Country:US
Practice Address - Phone:908-698-1751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2020-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03480300183500000X
GARPH027432183500000X
TX51230183500000X
VA0202212550183500000X
FL31556641835P1200X
FL61515871835P2201X
FLPS48759183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care