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NPI Code Detail

MEDICARE: EVENECER PHARMACY CORP

MEDICARE: EVENECER PHARMACY CORP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail PharmacyPH22344FL

General Provider Information

NPI Number : 1316026479
Entity Type Code : Organization
Provider Name (Legal Business Name) : EVENECER PHARMACY CORP
Provider Business Mailing Address
First Line : 441 NW 12TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33128-1020
Country : US
Telephone Number : 305-324-9395
Fax Number :
Provider Business Practice Location Address
First Line : 441 NW 12TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33128-1020
Country : US
Telephone Number : 305-324-9395
Fax Number :
Authorized Official
Title or Position : OWNER
Name : YISELL PEREZ
Credential :
Telephone Number : 305-324-9395
Provider Enumeration Date : 11/02/2006
Last Update Date : 08/22/2020

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Directions to “EVENECER PHARMACY CORP ” Practice Location

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