| NPI | 1619214616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHIMA KENNY Manager 407-757-0567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH26616) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: PA NP000008) |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2013-01-10 |
| Last Update Date | 2016-10-21 |