Organization
ESTONNA MANAGEMENT LLC
Active
Other names
Vitality Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID RUTLAND RPH (OWNER)
(239) 992-7633
Entity
Organization
Contact information
Practice address
3501 HEALTH CENTER BLVD, #1200, BONITA SPRINGS, FL 34135-8127
(239) 992-7633
(239) 992-7896
Mailing address
3501 HEALTH CENTER BLVD, #1200, BONITA SPRINGS, FL 34135-8127
(239) 992-7633
(239) 992-7896
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH25954
FL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2134226
PK
—
Enumeration date
02/29/2012
Last updated
01/21/2014
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