Icon Pharmacy

Primary specialty

Institutional PharmacyTaxonomy code 3336I0012X

License

PH21554 Issued in FL

Legal business name

ICON PHARMACY

Practice address

300 E Church St
Orlando, FL 32801-3544

Phone

(407) 649-8050

Fax

(407) 649-8051

NPI assigned

Aug 18, 2006

Organization subpart

No

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

Authorized official

Name

Ruben Garzon, RPH

Title

Pharmacist

Phone

(407) 649-8050

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841304730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 W RAHN RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454591431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E CHURCH ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328013544",
            "telephone_number": "407-649-8050",
            "fax_number": "407-649-8051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICON PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GARZON",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "407-649-8050",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "FL",
            "license": "PH21554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1015242",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Institutional Pharmacy in Orlando, FL
• Providers in Orlando, FL by specialty
• Institutional Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.