Organization
SUNRISE RX PHARMACY
Active
Other names
Sunrise Rx Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ELIER GONZALEZ MARTINEZ (PRESIDENT/ OWNER)
(239) 288-7450
Entity
Organization
Contact information
Practice address
2336 CLEVELAND AVE, FORT MYERS, FL 33901-3540
(239) 288-7450
(239) 288-7451
Mailing address
2336 CLEVELAND AVE, FORT MYERS, FL 33901-3540
(239) 288-7450
(239) 288-7451
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH26151
FL
3336C0004X
Compounding Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006433900
—
FL
01
—
2135241
PK
—
Enumeration date
04/16/2012
Last updated
09/15/2016
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