| NPI | 1679895767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNABELLY LUIS President 239-321-1002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH24535) |
| Enumeration Date | 2010-02-17 |
| Last Update Date | 2011-06-24 |