Organization
CIMO PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE REBELO RPH (OWNER)
(407) 977-3622
Entity
Organization
Contact information
Practice address
2235 EAGLE PASS RD, OVIEDO, FL 32765-9046
(407) 977-3622
(407) 977-3624
Mailing address
PO BOX 623157, OVIEDO, FL 32762-3157
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH21497
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1019555
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/10/2006
Last updated
08/22/2020
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