MEDICARE: EVENECER 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
1	333600000X	Pharmacy	PH21639	FL
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1016054	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1750324539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVENECER PHARMACY INC

Provider Business Mailing Address
First Line	:	441 NW 12TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33128-1020
Country	:	US
Telephone Number	:
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	:	305-324-9396

Authorized Official
Title or Position	:	PHCY CONSULTANT
Name	:	SILVIA MOTA CLEARE
Credential	:
Telephone Number	:	786-423-6008

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	09/11/2025

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Directions to “EVENECER PHARMACY INC ” Practice Location

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