Most Relevant Information
Provider Data
| NPI Number: | 1003410010 |
| Provider Name: | EMMILIA FONTAINE PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | PS60885 |
Most Important Dates
| Enumeration Date: | 11/30/2020 |
| Last Updated: | 11/30/2020 |
Provider Practice Location
1120 E KENNEDY BLVD
TAMPA
FL
336023580
Practice Location Phone/Fax
| Phone: | 8134966213 |
| Fax: |
Provider Mailing Location
1208 E LOUISIANA AVE
TAMPA
FL
336032504
Provider Mailing Phone/Fax
| Phone: | 8508666088 |
| Fax: |