# PUBLIX

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437553625
- **Authorized official:** DALE HOUSTON (MANAGER OF MANAGED CARE)
- **Authorized official phone:** (407) 366-9720

## Contact information

- **Practice address:** 4250 ALAFAYA TRL, OVIEDO, FL 32765-9412
- **Practice address phone:** (407) 366-9720
- **Mailing address:** 4250 ALAFAYA TRL, OVIEDO, FL 32765-9412

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183500000X | Pharmacist | PS52695 | FL | — |
| 1835P0018X | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | — | NULL | Yes |
| 1835P0018X | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | — | — | Yes |

## Other

- **Enumeration date:** 10/16/2014
- **Last updated:** 07/02/2021