| NPI | 1699810663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANIUS GOMEZ Store Manager 954-583-9433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH252) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-08-22 |