Active NPI
Healthdyne Pharmacy FL, LLC
Doing business as HealthDyne Pharmacy
- Community/Retail Pharmacy
- Lakeland, FL
National Provider Identifier
1265083729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- HEALTHDYNE PHARMACY FL, LLC
- Doing business as
- HealthDyne Pharmacy
- Practice address
- 500 Eagles Landing Dr
Lakeland, FL 33810-2899 - Phone
- (863) 583-6523
- NPI assigned
- Sep 26, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Phillip P. Bisesi
- Title
- Senior Vice President & Secretary
- Phone
- (863) 583-6248
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
500 Eagles Landing Dr
Lakeland, FL 33810-2899
Mailing address
500 Eagles Landing Dr
Lakeland, FL 33810-2899
Phone (863) 583-6523
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001055000 | Medicaid | FL | |
| 100080584 | Medicaid | WI | |
| 1024462370001 | Medicaid | PA | |
| 03285290 | Medicaid | MD | |
| 1017697 | Medicaid | VT | |
| 9000170493 | Medicaid | CO | |
| 1093974982 | Medicaid | MN | |
| 200636740A | Medicaid | KS | |
| 200972230A | Medicaid | IN | |
| 20200323899433 | Medicaid | MI | |
| 0205365 | Medicaid | IA | |
| 1093974982 | Medicaid | ID | |
| 1093974982 | Medicaid | WA | |
| 20029370A | Medicaid | OK |
Other names 1
- HealthDyne Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Healthdyne Pharmacy
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569456000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1755043200000",
"number": "1265083729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 EAGLES LANDING DR",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338102899",
"telephone_number": "863-583-6523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 EAGLES LANDING DR",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338102899",
"telephone_number": "863-583-6523"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEALTHDYNE PHARMACY FL, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-09-26",
"last_updated": "2025-08-13",
"certification_date": "2023-06-20",
"status": "A",
"authorized_official_last_name": "BISESI",
"authorized_official_first_name": "PHILLIP",
"authorized_official_middle_name": "P.",
"authorized_official_title_or_position": "SENIOR VICE PRESIDENT & SECRETARY",
"authorized_official_telephone_number": "863-583-6248"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001055000",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100080584",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1024462370001",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03285290",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1017697",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9000170493",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1093974982",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200636740A",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200972230A",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20200323899433",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0205365",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1093974982",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1093974982",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20029370A",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "HealthDyne Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lakeland, FL
- Healnexxt Woundcare LLC
- Health Holdings Company LLC (Palm Medical Centers South Lakeland)
- Health Logistic Services, LLC
- Healthcare Center of Tampa
- Healthdyne Pharmacy FL, LLC (HealthDyne Pharmacy)
- Healthdyne Pharmacy FL, LLC (HealthDyne Pharmacy)
- Healthdyne Specialty Florida, LLC (HealthDyne Specialty / WellDyne Specialty)
- Healthdyne Specialty Florida, LLC (HealthDyne Specialty / WellDyne Specialty)
- Healthdyne Specialty Florida, LLC
- Healthdyne Specialty Florida, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.