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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