Healthcare Provider Details

I. General information

NPI: 1003745779
Provider Name (Legal Business Name): DAMIAN MARIO SINCLAIR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7605 W 33RD CT
HIALEAH FL
33018-5003
US

IV. Provider business mailing address

3130 EXECUTIVE WAY
MIRAMAR FL
33025-4669
US

V. Phone/Fax

Practice location:
  • Phone: 305-557-6395
  • Fax:
Mailing address:
  • Phone: 954-378-7900
  • Fax: 954-378-7799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS41555
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: