| NPI | 1669651840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISVET MARTINEZ President 813-417-9860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH23040) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2013-10-26 |