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General NPI Number Information
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NPI Number | 1265496848
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Entity Type | Organization
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Legal Business Name | MOBILE INFUSION MANAGEMENT LLC
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 7353 WINDER CT
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City | LAKE WORTH
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State | FL
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Zip | 33467-7877
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Country | US
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Telephone | 561-635-0508
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Fax | 561-967-4240
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Provider Business Mailing Address
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Address Line | 7353 WINDER CT
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City | LAKE WORTH
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State | FL
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Zip | 33467-7877
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Country | US
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Telephone | 561-635-0508
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Fax | 561-967-4240
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. WILLIAM DAVID MUNIZ
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Credential | PHARM.D
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Telephone | 561-635-0508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PU5323
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License Number State | FL
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