Organization
IDEL PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ILLAN SUAREZ PHARM.D. MBA (PRESIDENT)
(813) 877-6679
Entity
Organization
Contact information
Practice address
3314 W COLUMBUS DR, TAMPA, FL 33607-1801
(813) 877-6679
(813) 877-1692
Mailing address
3314 W COLUMBUS DR, TAMPA, FL 33607-1801
(813) 877-6679
(813) 877-1692
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH7790
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104778700
—
FL
05
—
104778701
—
FL
Enumeration date
07/13/2006
Last updated
05/16/2023
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