Provider Demographics
NPI:1588330336
Name:ZAROCHAK, MICHAEL JOHN (RPH)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN
Last Name:ZAROCHAK
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 1:11428 CROWNED SPARROW LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-2666
Mailing Address - Country:US
Mailing Address - Phone:412-805-9862
Mailing Address - Fax:
Practice Address - Street 1:12500 STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:FL
Practice Address - Zip Code:33556-3480
Practice Address - Country:US
Practice Address - Phone:727-376-9490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS52237183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist