Basic Information
Provider Information
NPI: 1790880771
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TORLONE
FirstName: MICHAEL
MiddleName: LEE
NamePrefix: DR.
NameSuffix:  
Credential: PHARM.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5342 CONCORD WAY
Address2:  
City: FORT MYERS
State: FL
PostalCode: 339077811
CountryCode: US
TelephoneNumber: 2399393939
FaxNumber:  
Practice Location
Address1: 3033 WINKLER AVENUE EXT
Address2:  
City: FORT MYERS
State: FL
PostalCode: 339169413
CountryCode: US
TelephoneNumber: 2399393939
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/14/2006
LastUpdateDate: 07/31/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1835P1200XPS41584FLY Pharmacy Service ProvidersPharmacistPharmacotherapy

No ID Information.


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