Provider Demographics
NPI:1952771586
Name:ARVIDSON, RONALD THOMAS (RPH)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:THOMAS
Last Name:ARVIDSON
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 1:300 N CATTLEMEN RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6426
Mailing Address - Country:US
Mailing Address - Phone:941-341-9524
Mailing Address - Fax:941-341-9796
Practice Address - Street 1:300 N CATTLEMEN RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6426
Practice Address - Country:US
Practice Address - Phone:941-341-9524
Practice Address - Fax:941-341-9796
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS16563183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist