Organization
PHARMLAND
Active
Other names
Lifecare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS JUAN MAZARIEGOS PHARM D (CO-OWNER/PHARMACIST)
(727) 209-1282
Entity
Organization
Contact information
Practice address
3426 13TH AVE N, ST PETERSBURG, FL 33713-5424
(727) 209-1282
Mailing address
3426 13TH AVE N, ST PETERSBURG, FL 33713-5424
(727) 209-1282
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH23875
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000609300
—
FL
Enumeration date
02/02/2009
Last updated
10/09/2009
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