Organization
H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC.
Active
Other names
CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SOPHIA ALFONSO (PHARMACY MGR)
(813) 745-7354
Entity
Organization
Contact information
Practice address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
(813) 745-7354
(813) 745-1484
Mailing address
12902 USF MAGNOLIA DR, MAILSTOP: MCC-PHARM, TAMPA, FL 33612-9416
(813) 745-7354
(813) 745-1484
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
PH9513
FL
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109430100
—
FL
01
—
2007989
PK
—
Enumeration date
09/06/2006
Last updated
08/25/2020
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