Organization
PERFORMSPECIALTY, LLC
Active
Parent organization
PERFORMRX, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PERFORMRX, LLC
Authorized official
MR. ROBERT TOOTLE (SENIOR COUNSEL)
(215) 937-8561
Entity
Organization
Contact information
Practice address
2416 LAKE ORANGE DR, SUITE 190, ORLANDO, FL 32837-7812
(407) 956-1220
(407) 738-4802
Mailing address
2416 LAKE ORANGE DR, SUITE 190, ORLANDO, FL 32837-7812
(407) 956-1220
(407) 738-4802
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
PS28204
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012043200
—
FL
05
—
1029314380001
—
PA
Enumeration date
01/05/2015
Last updated
01/05/2015
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