| NPI | 1659640332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE DEJESUS Staff Pharmacist 813-752-6192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PS45210) |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2011-12-23 |