Provider Demographics
NPI:1699740175
Name:ALSPACH, MARK DAVID (PHARM D)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:DAVID
Last Name:ALSPACH
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 1:7915 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707-1019
Mailing Address - Country:US
Mailing Address - Phone:727-345-3540
Mailing Address - Fax:
Practice Address - Street 1:6449 38TH AVE N
Practice Address - Street 2:SUITE A4
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1655
Practice Address - Country:US
Practice Address - Phone:727-341-0149
Practice Address - Fax:727-345-2986
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS32488183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist