Individual
DR. DAVID BACON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15499 N DALE MABRY HWY APT 209, TAMPA, FL 33618-1822
(912) 223-2340
Mailing address
15499 N DALE MABRY HWY APT 209, TAMPA, FL 33618-1822
(813) 264-6803
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS51560
FL
Other
Enumeration date
04/30/2021
Last updated
04/30/2021
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