| NPI | 1467830638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZETTE WOOD Pharmacy Director 772-465-4442 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty (Licence: FL PH29049) |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2022-05-03 |