Organization
ICON PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUBEN GARZON RPH (PHARMACIST)
(407) 649-8050
Entity
Organization
Contact information
Practice address
300 E CHURCH ST, ORLANDO, FL 32801-3544
(407) 649-8050
(407) 649-8051
Mailing address
1371 W RAHN RD, DAYTON, OH 45459-1431
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
PH21554
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1015242
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/18/2006
Last updated
08/22/2020
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