Organization
PHYSICIAN FAMILY PHARMACY CORP
Active
Other names
Physician Family Pharmacy Compound and Mini Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELITA NICOLAS (OWNER)
(561) 501-1874
Entity
Organization
Contact information
Practice address
5869 LAKE WORTH RD, GREENACRES, FL 33463-3209
(561) 501-1874
Mailing address
5869 LAKE WORTH RD, GREENACRES, FL 33463-3209
(561) 501-1874
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235655069
—
FL
Enumeration date
01/21/2019
Last updated
01/21/2019
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