Organization Active NPI

Saint Cloud Pharmacy and Wellness Center Inc

  • Pharmacy
  • Saint Cloud, FL
National Provider Identifier
1396043261
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PH25210 Issued in FL
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

Updated by the provider on Jun 26, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Siby Thomas Puthenpurayil, RPHNPI 1003181033
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)CodeLicenseStatePrimary
Diabetes Educator Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 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 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200916002178 FL Part B Supplier - Independent Clinical Laboratory 9830495654 Practice locations: Saint Cloud, FL

National Provider Directory

National Provider Directory

Locations

4073 13th St
Saint Cloud, FL 34769
Phone (407) 733-3498

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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.

Verify at the official NPI Registry.