Individual
BRUK TESFAYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17021 US HIGHWAY 441, MOUNT DORA, FL 32757-6734
(352) 357-6904
Mailing address
17021 US HIGHWAY 441, MOUNT DORA, FL 32757-6734
(352) 357-6904
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
48626
FL
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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