| NPI | 1427562412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BHAGAVAN GOTTIPATI Pharmacy Manager/Owner 813-815-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH31046) |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2018-05-31 |