Individual
BRYAN ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1150 NE 26TH ST, WILTON MANORS, FL 33305-1245
(954) 566-7474
Mailing address
10406 SW 17TH DR, DAVIE, FL 33324-7460
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PS6540
FL
183500000X
Pharmacist
Primary
PS65460
FL
Other
Enumeration date
05/18/2023
Last updated
05/18/2023
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