Organization
MT. DORA PHARMACY LLC
Active
Other names
Mid Florida Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALPESH PATEL (OWNER)
(813) 304-2221
Entity
Organization
Contact information
Practice address
461-463 PLAZA DRIVE, EUSTIS, FL 32726
(352) 729-6557
(352) 385-7412
Mailing address
2722 W. OLD US HWY 441, MOUNT DORA, FL 32757
(352) 729-6557
(352) 385-7412
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH29311
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015852200
—
FL
01
—
2153608
PK
—
Enumeration date
08/25/2015
Last updated
09/09/2021
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