| NPI | 1952749632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILDRED PETERSIDE PIC/Owner 813-598-0593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH26712) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2013-06-04 |