Organization
KOTANATIONAL MERCANTILE INC
Active
Other names
cinderellon
Organization subpart
No
Provider details
NPI number
Authorized official
TONY F ORUKOTAN PHARM D (PRESIDENT)
(305) 751-2783
Entity
Organization
Contact information
Practice address
128 NE 54TH ST, MIAMI, FL 33137-2416
(305) 751-2783
(305) 758-3522
Mailing address
128 NE 54TH ST, MIAMI, FL 33137-2416
(305) 751-2783
(305) 758-3522
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH11215
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100748300
—
FL
Enumeration date
11/30/2009
Last updated
11/30/2009
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