Healthcare Provider Details

I. General information

NPI: 1700328473
Provider Name (Legal Business Name): TU SALUD PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2016
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 W 46 ST SUITE #5
HIALEAH FL
33012
US

IV. Provider business mailing address

1255 W 46 ST SUITE #5
HIALEAH FL
33012
US

V. Phone/Fax

Practice location:
  • Phone: 786-359-4283
  • Fax: 786-899-0980
Mailing address:
  • Phone: 786-359-4283
  • Fax: 786-899-0980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH30461
License Number StateFL

VIII. Authorized Official

Name: JASON ALONSO
Title or Position: PRESIDENT
Credential:
Phone: 786-359-4283