Healthcare Provider Details
I. General information
NPI: 1043140064
Provider Name (Legal Business Name): ICARE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3094 S ORLANDO DR
SANFORD FL
32773-5318
US
IV. Provider business mailing address
3094 S ORLANDO DR
SANFORD FL
32773-5318
US
V. Phone/Fax
- Phone: 407-766-5720
- Fax:
- Phone: 407-766-5720
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336M0002X |
| Taxonomy | Mail Order Pharmacy |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CAROLINE
YOUSSEF
Title or Position: OWNER/PHARMACIST IN CHARGE
Credential: PHARMD
Phone: 407-766-5720