Healthcare Provider Details

I. General information

NPI: 1639709454
Provider Name (Legal Business Name): MEDSTOP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2020
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2095 W FAIRBANKS AVE STE A
WINTER PARK FL
32789-4505
US

IV. Provider business mailing address

2095 W FAIRBANKS AVE STE A
WINTER PARK FL
32789-4505
US

V. Phone/Fax

Practice location:
  • Phone: 407-636-6115
  • Fax: 844-691-1066
Mailing address:
  • Phone: 407-636-6115
  • Fax: 844-691-1066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HARSH PATEL
Title or Position: PRESIDENT
Credential:
Phone: 407-636-6115