Healthcare Provider Details
I. General information
NPI: 1306244686
Provider Name (Legal Business Name): CFP MEDICAL SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/18/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6804 ALOMA AVE
WINTER PARK FL
32792-6802
US
IV. Provider business mailing address
PO BOX 4490
WINTER PARK FL
32793-4490
US
V. Phone/Fax
- Phone: 407-420-7996
- Fax: 888-633-8920
- Phone: 407-420-7996
- Fax: 888-633-8920
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | 28565 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 28565 |
| License Number State | FL |
VIII. Authorized Official
Name:
JONATHAN
SUH
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 407-420-7996