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SUNRISE PHARMACY OF KISSIMMEE LLC
STD330301 FLORIMED MEDICAL CENTER
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Covered Entity Details
Entity Name
FLORIMED MEDICAL CENTER
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD330301
Entity Address
311 N.E. 8 STREET
SUITE 110
HOMESTEAD, FL 33030
Grant Number
NH25P5004342
Participating Start Date
8/26/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
SUNRISE PHARMACY OF KISSIMMEE LLC
Pharmacy Address
SUNRISE PHARMACY
4543 PLEASANT HILL RD STE D
KISSIMMEE, FL 34759-3406
Pharmacy Comments
Contract Details
Approval Date
7/2/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/27/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Tomas Wharton, CEO
(305) 834-9942
Contract Pharmacy Representative
Sunrise Pharmacy
Srilatha K, Manager
(407) 343-4434
Signed By Date
7/2/2020
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