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Regent Crisostomo

Pharmacist in Kissimmee, FL. Individual provider (NPI-1).

NPI number1497516009
StatusActive
Last updated in NPPESJan 22, 2024

Details

NPI
1497516009
Entity type
Individual (NPI-1)
Name
Regent Crisostomo
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 22, 2024
Certification date
Jan 20, 2024
Last updated
Jan 22, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
183500000X PharmacistPS58203FLYes

Practice location

1205 W Vine St
Kissimmee, FL 34741-4046

Phone 407-847-5174

Mailing address

1205 W Vine St
Kissimmee, FL 34741-4046

Phone 407-847-5174

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