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General NPI Number Information
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NPI Number | 1093974982
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Entity Type | Organization
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Legal Business Name | HEALTHDYNE PHARMACY FL, LLC
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 500 EAGLES LANDING DR
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City | LAKELAND
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State | FL
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Zip | 33810-2899
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Country | US
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Telephone | 888-479-2000
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Fax | 863-686-5682
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Provider Business Mailing Address
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Address Line | 500 EAGLES LANDING DR
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City | LAKELAND
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State | FL
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Zip | 33810-2899
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Country | US
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Telephone | 888-479-2000
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Fax | 863-686-4710
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT&SECRETARY
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Name | PHILLIP P BISESI
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Credential |
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Telephone | 863-583-6248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number | PH23389
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License Number State | FL
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