| NPI | 1992273023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIEGO GOMEZ Owner Pharmacy Manager 941-204-1610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2025-08-21 |