LIFE SPECIALTY PHARMACY INC NPI 1063650612

NPI Information

  • NPI: 1063650612
  • Provider Name: LIFE SPECIALTY PHARMACY, INC
  • Classification: Pharmacy - 3336C0004X
  • Specialization: Compounding Pharmacy
  • Entity Type: Organization
  • Doing Business As: LIFE SPECIALTY PHARMACY, INC
  • Address: 1507 PARK CENTER DR
    SUITE 1L
    ORLANDO, FL
    ZIP 32835
  • Phone: (407) 522-5683

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NPI Details

LIFE SPECIALTY PHARMACY, INC is a compounding pharmacy pharmacy in Orlando, FL. The provider is a pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. LIFE SPECIALTY PHARMACY, INC NPI is 1063650612. The provider is registered as an organization entity type.
The provider Is Doing Business As Life Specialty Pharmacy, Inc.

The provider's business location address is:

1507 PARK CENTER DR
SUITE 1L
ORLANDO, FL
ZIP 32835-795
Phone: (407) 522-5683
Fax: (407) 522-5684

The provider's authorized official is Michael Ayotunde .
The authorized official title is Pharmacist and has the following contact phone number (407) 522-5683.

The enumeration date for this NPI number is 2/4/2009 and was last updated on 4/29/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyNo
33336C0003XPharmacyCommunity/Retail PharmacyNo
43336H0001XPharmacyHome Infusion Therapy PharmacyNo
53336L0003XPharmacyLong Term Care PharmacyNo
63336S0011XPharmacySpecialty PharmacyNo
73336C0004XPharmacyCompounding PharmacyPH23699FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11042009OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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