Healthcare Provider Details

I. General information

NPI: 1376924266
Provider Name (Legal Business Name): UNIVITA OF FLORIDA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2015
Last Update Date: 06/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2252 COMMERCE PARK DR STE 100
ORLANDO FL
32819-8609
US

IV. Provider business mailing address

15800 SW 25TH ST
MIRAMAR FL
33027-4222
US

V. Phone/Fax

Practice location:
  • Phone: 954-333-1000
  • Fax:
Mailing address:
  • Phone: 954-333-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL A MUCHNICKI
Title or Position: CEO
Credential:
Phone: 954-333-1000