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NPI Code Detail

MEDICARE: STA AMALIA PHARMACY, INC.

MEDICARE: STA AMALIA PHARMACY, INC.
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
1333600000XPharmacyPH21675FL
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11016307OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
21016307OTHERFLNCPDP
3PH21675OTHERFLSTATE LICENSE

General Provider Information

NPI Number : 1740223593
Entity Type Code : Organization
Provider Name (Legal Business Name) : STA AMALIA PHARMACY, INC.
Provider Business Mailing Address
First Line : 2170 NW 7TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33125-3425
Country : US
Telephone Number : 305-631-8330
Fax Number :
Provider Business Practice Location Address
First Line : 2170 NW 7TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33125-3425
Country : US
Telephone Number : 305-631-8330
Fax Number : 305-631-8723
Authorized Official
Title or Position : PRESIDENT
Name : ANTONIO M PEREZ
Credential :
Telephone Number : 305-631-8330
Provider Enumeration Date : 06/13/2006
Last Update Date : 03/07/2023

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Directions to “STA AMALIA PHARMACY, INC. ” Practice Location

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