Healthcare Provider Details

I. General information

NPI: 1437074457
Provider Name (Legal Business Name): COCOA BEACH DISCOUNT PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 W COCOA BEACH CSWY
COCOA BEACH FL
32931-3529
US

IV. Provider business mailing address

291 W COCOA BEACH CSWY
COCOA BEACH FL
32931-3529
US

V. Phone/Fax

Practice location:
  • Phone: 321-799-2030
  • Fax: 321-799-2050
Mailing address:
  • Phone: 321-799-2030
  • Fax: 321-799-2050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BHUPENDRAKUMAR V PATEL
Title or Position: PHARMACY MANAGER
Credential:
Phone: 321-799-2030