| NPI | 1619335601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERYCK KARL JOSEPHS Pharmacist/Owner 813-689-9489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: FL PH 27215) |
| Enumeration Date | 2016-02-04 |
| Last Update Date | 2016-02-04 |