Healthcare Provider Details

I. General information

NPI: 1275991515
Provider Name (Legal Business Name): VOLITION GROUP CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2016
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 SR 436
FERN PARK FL
32730
US

IV. Provider business mailing address

125 SR 436
FERN PARK FL
32730
US

V. Phone/Fax

Practice location:
  • Phone: 407-636-8733
  • Fax: 407-386-3245
Mailing address:
  • Phone: 407-636-8733
  • Fax: 407-386-3245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH29812
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PASCHAL NZERUE
Title or Position: PRESIDENT
Credential: PHARM.D
Phone: 786-262-6040