Individual
MR. AI TI PAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
4686 E MICHIGAN ST, ORLANDO, FL 32812-5234
(407) 277-1912
(407) 277-2026
Mailing address
4819 FORT LEE CT, ORLANDO, FL 32822-7100
(407) 382-5931
(407) 382-5931
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS0028034
FL
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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