OrganizationActive
Life Specialty Pharmacy, Inc
NPI 1063650612 · Compounding Pharmacy · Orlando, FL
Provider details
- NPI number
- 1063650612
- Entity type
- Organization
- Primary specialty
- Compounding PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Michael Ayotunde, Pharmacist(407) 522-5683
Specialties & taxonomies
Suppliers
Suppliers
- Pharmacy333600000X
Suppliers
- Community/Retail Pharmacy3336C0003X
Suppliers
- Home Infusion Therapy Pharmacy3336H0001X
Suppliers
- Long Term Care Pharmacy3336L0003X
Suppliers
- Specialty Pharmacy3336S0011X
Suppliers
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1507 Park Center Dr
Suite 1l
Orlando, FL 32835-5795
Phone: (407) 522-5683
Fax: (407) 522-5684
Street-level locationGet directions
Mailing address
1507 Park Center Dr
Orlando, FL 32835-5795
Other names (DBA / former)
- Doing business as
- Life Specialty Pharmacy, Inc
Registry dates
- Enumerated
- 2009-02-04
- Last updated
- 2009-04-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.