Healthcare Provider Details

I. General information

NPI: 1548351422
Provider Name (Legal Business Name): CERVER PHARMACY CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 04/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2711 SW 37TH AVE
COCONUT GROVE FL
33133-2727
US

IV. Provider business mailing address

2711 SW 37TH AVE
COCONUT GROVE FL
33133-2727
US

V. Phone/Fax

Practice location:
  • Phone: 305-441-2425
  • Fax:
Mailing address:
  • Phone: 305-441-2425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH 21768
License Number StateFL

VIII. Authorized Official

Name: ELIZABETH MARIA CHONG
Title or Position: PRESIDENT
Credential:
Phone: 305-441-2425