| NPI | 1407392905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER MARIE CONNELLY Mtm Pharmacist 352-273-9045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS55614) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2017-01-09 |