Provider Demographics
NPI:1336549880
Name:MUSE DYNAMICS
Entity Type:Organization
Organization Name:MUSE DYNAMICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AGNUS
Authorized Official - Middle Name:MUSE
Authorized Official - Last Name:COMMEDORE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:561-245-0235
Mailing Address - Street 1:10814 CELTIC WOODS AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-4036
Mailing Address - Country:US
Mailing Address - Phone:561-245-0235
Mailing Address - Fax:813-438-5182
Practice Address - Street 1:10814 CELTIC WOODS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-4036
Practice Address - Country:US
Practice Address - Phone:561-245-0235
Practice Address - Fax:813-438-5182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43920183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty