Provider Demographics
NPI:1194166793
Name:MCKEON, PATRICK JAMES II (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JAMES
Last Name:MCKEON
Suffix:II
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 E PALM AVE
Mailing Address - Street 2:APT 4103
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33605-3938
Mailing Address - Country:US
Mailing Address - Phone:813-817-3282
Mailing Address - Fax:
Practice Address - Street 1:5125 PALM SPRINGS BLVD
Practice Address - Street 2:UNIT 12302
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-5013
Practice Address - Country:US
Practice Address - Phone:813-817-3282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPSI28976390200000X
FLPS53318183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program