Healthcare Provider Details

I. General information

NPI: 1376489526
Provider Name (Legal Business Name): TRUE LIGHT HEALTHHUB PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13526 VILLAGE PARK DR
ORLANDO FL
32837-7685
US

IV. Provider business mailing address

13526 VILLAGE PARK DR
ORLANDO FL
32837-7685
US

V. Phone/Fax

Practice location:
  • Phone: 772-321-9963
  • Fax: 772-321-9963
Mailing address:
  • Phone: 772-321-9963
  • Fax: 772-321-9963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PETER B SHEHATA
Title or Position: OWNER
Credential:
Phone: 772-321-9963