Provider Demographics
NPI:1386806529
Name:BOTTIGLIERI, SALVATORE MICHAEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:MICHAEL
Last Name:BOTTIGLIERI
Suffix:
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 1:12902 MAGNOLIA DRIVE
Mailing Address - Street 2:MOFFITT CANCER CENTER, DEPT OF PHARMACY
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612
Mailing Address - Country:US
Mailing Address - Phone:914-403-0226
Mailing Address - Fax:
Practice Address - Street 1:12902 MAGNOLIA DRIVE
Practice Address - Street 2:MOFFITT CANCER CENTER, DEPT OF PHARMACY
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612
Practice Address - Country:US
Practice Address - Phone:914-403-0226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19604183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist