Healthcare Provider Details

I. General information

NPI: 1265447817
Provider Name (Legal Business Name): ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 06/26/2024
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 WESLEY RD STE 110
APOPKA FL
32712-5908
US

IV. Provider business mailing address

5050 WESLEY RD STE 110
APOPKA FL
32712-5908
US

V. Phone/Fax

Practice location:
  • Phone: 866-943-4535
  • Fax: 407-805-8545
Mailing address:
  • Phone: 407-357-2600
  • Fax: 407-805-8545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License NumberPH22100
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TRENIA YIELDING
Title or Position: DIRECTOR/PHARMACIST
Credential: PHARMD
Phone: 407-357-2600