Provider Demographics
NPI:1881939312
Name:WELLNESS RX TAMPA LLC
Entity type:Organization
Organization Name:WELLNESS RX TAMPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESCRIPTION DEOARTMENT MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MARIO
Authorized Official - Last Name:PARRADO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:813-304-2266
Mailing Address - Street 1:7208 N STERLING AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-4228
Mailing Address - Country:US
Mailing Address - Phone:813-304-2266
Mailing Address - Fax:813-304-2268
Practice Address - Street 1:7208 N STERLING AVE
Practice Address - Street 2:SUITE B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-4228
Practice Address - Country:US
Practice Address - Phone:813-304-2266
Practice Address - Fax:813-304-2268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH265373336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy