Organization
MARCO ISLAND PHARMACY 2 LLC
Active
Other names
Golden Gate Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ORESTES VERDURA (MANAGER)
(239) 315-4821
Entity
Organization
Contact information
Practice address
5475 GOLDEN GATE PKWY STE 5W, NAPLES, FL 34116-7529
(239) 315-4823
(239) 315-4824
Mailing address
5475 GOLDEN GATE PKWY STE 5W, NAPLES, FL 34116-7529
(239) 315-4823
(239) 315-4824
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
HCC12895
FL
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH30812
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2170086
PK
—
Enumeration date
06/27/2017
Last updated
06/06/2019
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