Healthcare Provider Details

I. General information

NPI: 1306126701
Provider Name (Legal Business Name): CMA MEDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2011
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 W 68TH ST SUITE 200
HIALEAH FL
33016-1802
US

IV. Provider business mailing address

1000 PARK CENTRE BLVD SUITE 100
MIAMI FL
33169-5373
US

V. Phone/Fax

Practice location:
  • Phone: 305-827-2977
  • Fax:
Mailing address:
  • Phone: 305-621-0023
  • Fax: 305-628-6121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License NumberME88821
License Number StateFL

VIII. Authorized Official

Name: LEONOR ROSARIO
Title or Position: ADMINISTRATIVE ASSISTANT
Credential:
Phone: 305-628-6136