Active NPI
Saint Cloud Pharmacy and Wellness Center Inc
- Pharmacy
- Saint Cloud, FL
National Provider Identifier
1396043261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- PH25210
- Legal business name
- SAINT CLOUD PHARMACY AND WELLNESS CENTER INC
- Doing business as
- ST. CLOUD PHARMACY & WELLNESS CENTER
- Practice address
- 2801 13TH St
Saint Cloud, FL 34769-4134 - Phone
- (407) 593-2959
- Fax
- (407) 593-2957
- NPI assigned
- Mar 2, 2011
- 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
- Mr. Siby Thomas Puthenpurayil, RPH
- Title
- Pharmacist
- Phone
- (407) 593-2959
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diabetes Educator Registered Nurse | 163WD0400X | |||
| Pharmacy | 333600000X | PH25210 | FL | Primary |
Addresses
Primary practice location
2801 13TH St
Saint Cloud, FL 34769-4134
Mailing address
2801 13TH St
Saint Cloud, FL 34769-4134
Phone (407) 593-2959
Other names 1
- ST. CLOUD PHARMACY & WELLNESS CENTER
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200916002178 | FL | Part B Supplier - Independent Clinical Laboratory | 9830495654 | Practice locations: Saint Cloud, FL |
National Provider Directory
National Provider DirectoryLocations
4073 13th St
Saint Cloud, FL 34769
Phone (407) 733-3498
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Saint Cloud, FL
- NPI 1003181033
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299024000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1782432000000",
"number": "1396043261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 13TH ST",
"city": "SAINT CLOUD",
"state": "FL",
"postal_code": "347694134",
"telephone_number": "407-593-2959",
"fax_number": "407-593-2957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 13TH ST",
"city": "SAINT CLOUD",
"state": "FL",
"postal_code": "347694134",
"telephone_number": "407-593-2959",
"fax_number": "407-593-2957"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAINT CLOUD PHARMACY AND WELLNESS CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2011-03-02",
"last_updated": "2026-06-26",
"certification_date": "2026-06-26",
"status": "A",
"authorized_official_last_name": "PUTHENPURAYIL",
"authorized_official_first_name": "SIBY",
"authorized_official_middle_name": "THOMAS",
"authorized_official_title_or_position": "PHARMACIST",
"authorized_official_telephone_number": "407-593-2959",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "163WD0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Diabetes Educator",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "FL",
"license": "PH25210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "ST. CLOUD PHARMACY & WELLNESS CENTER",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Saint Cloud, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.