| NPI | 1740580463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD ISLAM Pharmacist In Charge 352-460-0542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH24952) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2010-10-28 |
| Last Update Date | 2010-10-28 |