Provider Demographics
NPI:1447706940
Name:VOURLOUMIS, JOANNA KONSTANTINA (PHARMD)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:KONSTANTINA
Last Name:VOURLOUMIS
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 1:4708 BAY CREST DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4402
Mailing Address - Country:US
Mailing Address - Phone:813-928-9100
Mailing Address - Fax:
Practice Address - Street 1:1313 S DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5010
Practice Address - Country:US
Practice Address - Phone:813-258-9301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS55410183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist