Individual ProviderJohannes Jacobus BotesPharmacistPharmacy Service ProvidersPractice Address1920 Aloma Ave, Winter Park, FL 32792-3207(407) 628-1899PECOS EnrollmentBased on the most recent information from CMS, provider Johannes Jacobus Botes does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1215207881Provider TypeIndividualFull NameBotes, Johannes JacobusTitleMr.CredentialBSCPHARMGenderMaleSole ProprietorYesEnumeration Date1/12/2012Last Updated1/12/2012Contact InformationPractice LocationPractice Address1920 Aloma Ave, Winter Park, FL 32792-3207Phone(407) 628-1899Fax(407) 628-8842Mailing LocationMailing Address1920 Aloma Ave, Winter Park, FL 32792-3207Phone(407) 628-1899Fax(407) 628-8842Provider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicensePS37510Florida