Healthcare Provider Details

I. General information

NPI: 1790503548
Provider Name (Legal Business Name): ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 10/01/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 WESLEY RD STE 120
APOPKA FL
32712-5908
US

IV. Provider business mailing address

5050 WESLEY RD STE 120
APOPKA FL
32712-5908
US

V. Phone/Fax

Practice location:
  • Phone: 855-440-9068
  • Fax: 407-805-8545
Mailing address:
  • Phone: 855-440-9068
  • Fax: 407-805-8545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DANA LEIGH WEATHERBY
Title or Position: PHARMACY MANAGER
Credential: PHARMD
Phone: 407-357-2618