Organization
BALDOMERO LOPEZ STATE VETERANS NURSING HOME
Active
Other names
BALDOMERO LOPEZ STATE VETERANS NURSING HOME
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY MIRANDA (PHARMACY MANAGER)
(813) 558-5000
Entity
Organization
Contact information
Practice address
6919 PARKWAY BLVD, LAND O LAKES, FL 34639-2909
(813) 558-5000
(813) 558-5018
Mailing address
6919 PARKWAY BLVD, LAND O LAKES, FL 34639-2909
(813) 558-5000
(813) 558-5018
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PH16499
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021491400
—
FL
01
—
2012484
PK
—
Enumeration date
03/02/2007
Last updated
06/20/2016
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