Healthcare Provider Details

I. General information

NPI: 1376540914
Provider Name (Legal Business Name): MARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5350 PALM AVE
HIALEAH FL
33012-2746
US

IV. Provider business mailing address

5350 PALM AVE
HIALEAH FL
33012-2746
US

V. Phone/Fax

Practice location:
  • Phone: 305-823-0915
  • Fax: 305-823-4055
Mailing address:
  • Phone: 305-823-0915
  • Fax: 305-823-4055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH9053
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number022474001
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH9053
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH9053
License Number StateFL

VIII. Authorized Official

Name: MRS. ANA NELIDA CABRERA
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 305-823-0915