Healthcare Provider Details

I. General information

NPI: 1194892596
Provider Name (Legal Business Name): ISABELA PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 NW 42ND AVE LEJEUNE RD
MIAMI FL
33126
US

IV. Provider business mailing address

260 NW 42ND AVE LEJEUNE RD
MIAMI FL
33126
US

V. Phone/Fax

Practice location:
  • Phone: 305-443-9666
  • Fax: 305-443-8969
Mailing address:
  • Phone: 305-443-9666
  • Fax: 305-443-8969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH223071
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. ALEIDA SOLADO
Title or Position: OWNER DIRECTOR
Credential:
Phone: 305-443-9666