{"npi":"1255698122","type":"NPI-2","status":"active","name":{"display":"Nova Pharmacy Corp","other":[],"organization_name":"NOVA PHARMACY CORP","authorised_official":"Mahe Marrero"},"specialty":{"primary_taxonomy":"3336C0003X","primary_taxonomy_description":"Community/Retail Pharmacy","slug":"community-retail-pharmacy","schema_org_specialty":null,"all":[{"code":"3336C0003X","description":"Community/Retail Pharmacy","primary":true,"state":"FL","license":"PH25860"}]},"addresses":[{"purpose":"LOCATION","street_1":"950 1ST ST S STE 103","city":"WINTER HAVEN","state":"FL","postal_code":"338803607","country_code":"US","phone":"3052626682","fax":"3052644318"},{"purpose":"MAILING","street_1":"950 1ST ST S STE 103","city":"WINTER HAVEN","state":"FL","postal_code":"338803607","country_code":"US","phone":"3052626682","fax":"3052644318"}],"license":{"state":"FL","number":"PH25860"},"identifiers":[{"type_code":"01","label":"Other","value":"5710226","state":"FL","issuer":"NCPDP"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20171212001545","type_code":"30-A5","type_desc":"DME SUPPLIER - PHARMACY","state":"FL","pac_id":"2264790658"},{"enrlmt_id":"O20211102000875","type_code":"12-A5","type_desc":"PART B SUPPLIER - PHARMACY","state":"FL","pac_id":"2264790658"}]},"enumeration_date":"2012-04-17","last_updated":"2021-09-29","_meta":{"source":"NPPES","snapshot_date":"2021-09-29","doc_url":"https://findmynpi.com/api"}}