Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
Oct 7, 2022
License(s)
PS64069 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 6085 W IRLO BRONSON MEMORIAL HWY | Kissimmee, FL 34747-4512 | 407-705-4846 |
| LOCATION | 6085 W IRLO BRONSON MEMORIAL HWY | Kissimmee, FL 34747-4512 | 407-705-4846 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.