Healthcare Provider Details

I. General information

NPI: 1740104124
Provider Name (Legal Business Name): CAPE CORAL FAMILY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1634 SE 47TH ST STE 16
CAPE CORAL FL
33904-8739
US

IV. Provider business mailing address

1634 SE 47TH ST STE 16
CAPE CORAL FL
33904-8739
US

V. Phone/Fax

Practice location:
  • Phone: 239-217-0397
  • Fax: 239-217-0401
Mailing address:
  • Phone: 239-217-0397
  • Fax: 239-217-0401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: YOSNEY VAZQUEZ QUINTANA
Title or Position: PRES
Credential:
Phone: 239-217-0397