| NPI | 1427699610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG SICINSKI Director 407-898-1331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2022-03-02 |