Healthcare Provider Details

I. General information

NPI: 1710908587
Provider Name (Legal Business Name): LDC PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9676 NW 25TH ST
DORAL FL
33172-1403
US

IV. Provider business mailing address

9676 NW 25TH ST
DORAL FL
33172-1403
US

V. Phone/Fax

Practice location:
  • Phone: 305-513-4480
  • Fax: 305-513-4940
Mailing address:
  • Phone: 305-513-4480
  • Fax: 305-513-4940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH21853
License Number StateFL

VIII. Authorized Official

Name: TANIA ALVAREZ
Title or Position: PRESIDENT
Credential:
Phone: 305-513-4480