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General NPI Number Information
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NPI Number | 1518466275
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Entity Type | Organization
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Legal Business Name | BUENO PHARMACY LLC
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Dates
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Enumeration Date | 02/08/2018
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 2921 S ORLANDO DR STE 130
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City | SANFORD
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State | FL
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Zip | 32773-4106
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Country | US
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Telephone | 646-202-3418
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Fax |
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Provider Business Mailing Address
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Address Line | 2921 S ORLANDO DR STE 130
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City | SANFORD
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State | FL
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Zip | 32773-4106
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MRG
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Name | ANTHONY MALDONADO
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Credential |
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Telephone | 646-202-3418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH31155
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License Number State | FL
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