Healthcare Provider Details

I. General information

NPI: 1851632970
Provider Name (Legal Business Name): JONELEEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2013
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 W SR 434 STE P
LONGWOOD FL
32750-4937
US

IV. Provider business mailing address

715 W SR 434 STE P
LONGWOOD FL
32750-4937
US

V. Phone/Fax

Practice location:
  • Phone: 321-677-7733
  • Fax: 352-597-0019
Mailing address:
  • Phone: 321-677-7733
  • Fax: 352-597-0019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH26746
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: DANIEL MUSCA
Title or Position: MANAGER
Credential:
Phone: 813-803-7303