Provider Demographics
NPI:1194919191
Name:LANNIGAN, JEFFRY PAUL (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JEFFRY
Middle Name:PAUL
Last Name:LANNIGAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13315 73RD AVE
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33776-4220
Mailing Address - Country:US
Mailing Address - Phone:813-290-6200
Mailing Address - Fax:813-283-3051
Practice Address - Street 1:6015 BENJAMIN RD
Practice Address - Street 2:SUITE #302
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-5179
Practice Address - Country:US
Practice Address - Phone:813-290-6200
Practice Address - Fax:813-283-3051
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-02
Last Update Date:2007-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS21748183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist