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General NPI Number Information
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NPI Number | 1265065783
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Entity Type | Organization
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Legal Business Name | PREVENT RX 2, LLC
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Dates
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Enumeration Date | 02/13/2020
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 3677 CENTRAL AVE STE A
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City | FORT MYERS
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State | FL
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Zip | 33901-8226
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Country | US
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Telephone | 239-243-9025
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Fax | 877-470-9723
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Provider Business Mailing Address
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Address Line | 17389 TYLER AVE
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948-1302
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Country | US
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Telephone | 239-243-9025
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Fax | 877-470-9723
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Authorized Official
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Title or Position | OWNER
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Name | AMBIORIX MORA ESTEVEZ
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Credential |
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Telephone | 201-927-9776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty 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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