| NPI | 1194239780 |
|---|---|
| Doing Business As | IMA WEST TAMPA DISPENSARY |
| Entity Type | Organization |
| Authorized Contact | PATRICIA D PEREZ COO 407-845-0330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ACN515) |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2017-11-20 |