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General NPI Number Information
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NPI Number | 1538819958
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Entity Type | Organization
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Legal Business Name | FLORIDA DEPARTMENT OF VETERANS' AFFAIRS
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Dates
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Enumeration Date | 03/28/2022
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 5255 RAYMOND ST
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City | ORLANDO
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State | FL
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Zip | 32814-6974
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Country | US
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Telephone | 407-741-4614
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Fax |
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Provider Business Mailing Address
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Address Line | 5255 RAYMOND ST
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City | ORLANDO
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State | FL
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Zip | 32814-6974
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Country | US
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Telephone | 407-741-4614
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Fax |
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Authorized Official
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Title or Position | DIRECTOR FDVA HOMES
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Name | CONNIE SUE TOLLEY
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Credential |
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Telephone | 727-518-3203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332100000X
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Taxonomy Name | Department of Veterans Affairs (VA) Pharmacy
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License Number |
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License Number State |
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