Provider Demographics
NPI:1326210360
Name:AMATO, DAVID BRADLEY (RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:BRADLEY
Last Name:AMATO
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 1:6870 SE 144TH PLACE RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-3200
Mailing Address - Country:US
Mailing Address - Phone:352-347-5485
Mailing Address - Fax:352-751-6302
Practice Address - Street 1:3475 WEDWOOD LANE
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162
Practice Address - Country:US
Practice Address - Phone:352-751-6302
Practice Address - Fax:352-751-6315
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS34854183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist