| NPI | 1053762260 |
|---|---|
| Doing Business As | NORTHLAKE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SALIM SOUFAN Owner/Pharmacist/AO 561-562-2610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH30206) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2017-03-14 |