Healthcare Provider Details

I. General information

NPI: 1720994429
Provider Name (Legal Business Name): NYAN CARES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N ASHLEY DR STE 2637
TAMPA FL
33602-4300
US

IV. Provider business mailing address

400 N ASHLEY DR STE 2637
TAMPA FL
33602-4300
US

V. Phone/Fax

Practice location:
  • Phone: 813-770-3472
  • Fax:
Mailing address:
  • Phone: 813-770-3472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. KENDRA ELLIS
Title or Position: PHARMACY MANAGER, PROGRAM DIRECTOR
Credential: PHARMD RPH
Phone: 813-770-3472