Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
Aug 14, 2025
License(s)
PS69343 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 220 BARTON BLVD UNIT C-14 | Rockledge, FL 32955-2742 | 321-241-6800 |
| MAILING | PO BOX 1137 | Melbourne, FL 32902-1137 | 321-952-9696 |
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.