Provider Demographics
NPI:1427172972
Name:GOULD, DALE (RPH)
Entity type:Individual
Prefix:MS
First Name:DALE
Middle Name:
Last Name:GOULD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 PALM VIEW RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-8816
Mailing Address - Country:US
Mailing Address - Phone:941-371-1794
Mailing Address - Fax:
Practice Address - Street 1:5400 FRUITVILLE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6403
Practice Address - Country:US
Practice Address - Phone:941-342-8686
Practice Address - Fax:941-371-2055
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0015968183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist