Organization
HEALTHDYNE PHARMACY FL, LLC
Active
Organization
HEALTHDYNE PHARMACY FL, LLC
Active
Other names
HealthDyne Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP P. BISESI (SENIOR VICE PRESIDENT & SECRETARY)
(863) 583-6248
Entity
Organization
Contact information
Practice address
500 EAGLES LANDING DR, LAKELAND, FL 33810-2899
(863) 583-6523
Mailing address
500 EAGLES LANDING DR, LAKELAND, FL 33810-2899
(863) 583-6523
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001055000
—
FL
05
—
0205365
—
IA
05
—
03285290
—
MD
05
—
100080584
—
WI
05
—
1017697
—
VT
05
—
1024462370001
—
PA
05
—
1093974982
—
ID
05
—
1093974982
—
MN
05
—
1093974982
—
WA
05
—
20029370A
—
OK
05
—
200636740A
—
KS
05
—
200972230A
—
IN
05
—
20200323899433
—
MI
05
—
9000170493
—
CO
Enumeration date
09/26/2019
Last updated
08/13/2025
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