Healthcare Provider Details

I. General information

NPI: 1386831105
Provider Name (Legal Business Name): CENTERWELL PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18623 S DIXIE HWY
CUTLER BAY FL
33157-6804
US

IV. Provider business mailing address

10749 MARKS WAY
MIRAMAR FL
33025-3976
US

V. Phone/Fax

Practice location:
  • Phone: 305-278-0763
  • Fax: 305-278-0831
Mailing address:
  • Phone: 800-526-1489
  • Fax: 800-526-1491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH22937
License Number StateFL

VIII. Authorized Official

Name: SEAN LYSINGER
Title or Position: VP
Credential:
Phone: 502-580-2376