Individual
IVAN EVERETTE GRIGGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
13711 S TAMIAMI TRL, FORT MYERS, FL 33912-1649
(850) 305-1293
Mailing address
4903 EDITH ESPLANADE, CAPE CORAL, FL 33904-5617
(850) 305-1293
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PS57639
FL
3336C0003X
Community/Retail Pharmacy
Primary
PS57639
FL
Other
Enumeration date
11/22/2020
Last updated
11/22/2020
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