| NPI | 1205235686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL M DOUGLAS President 786-842-3840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: FL PH28433) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: FL PH28433) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH28433) | |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: FL PH28433) | |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-08-21 |