Healthcare Provider Details

I. General information

NPI: 1952720963
Provider Name (Legal Business Name): ZUMA PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 04/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

554 HIALEAH DR
HIALEAH FL
33010-5349
US

IV. Provider business mailing address

554 HIALEAH DR
HIALEAH FL
33010-5349
US

V. Phone/Fax

Practice location:
  • Phone: 786-502-8290
  • Fax: 786-502-8136
Mailing address:
  • Phone: 786-502-8290
  • Fax: 786-502-8136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateFL

VIII. Authorized Official

Name: RUBEN DE LA RUA
Title or Position: PRESIDENT
Credential:
Phone: 786-502-8290