Healthcare Provider Details

I. General information

NPI: 1316899503
Provider Name (Legal Business Name): THE HEALTH MALL PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1782 W FLAGLER ST
MIAMI FL
33135-2017
US

IV. Provider business mailing address

1782 W FLAGLER ST
MIAMI FL
33135-2017
US

V. Phone/Fax

Practice location:
  • Phone: 305-519-0575
  • Fax: 305-998-4963
Mailing address:
  • Phone: 305-519-0575
  • Fax: 305-998-4963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1835P1400X
TaxonomyPain Management Pharmacist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: YUDAISY B HERNANDEZ
Title or Position: CEO
Credential:
Phone: 305-519-0575