| NPI | 1174517452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELVIN MONTANEZ COO 407-830-8820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: FL PH10680) |
| Additional Taxonomies | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: FL PH10680) | |
| 333600000X Pharmacy (Licence: FL Ph10680) | |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2022-08-19 |