Provider Demographics
NPI:1871161505
Name:PESCATORE, THOMAS FRANCIS (RPH)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:FRANCIS
Last Name:PESCATORE
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 1:6303 CORMORANT CT
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-7103
Mailing Address - Country:US
Mailing Address - Phone:941-518-4774
Mailing Address - Fax:
Practice Address - Street 1:6303 CORMORANT CT
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-7103
Practice Address - Country:US
Practice Address - Phone:941-518-4774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37258183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS37258OtherPHARMACY