Healthcare Provider Details

I. General information

NPI: 1578441937
Provider Name (Legal Business Name): GEMA JACOMINO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 NW 12TH AVE
MIAMI FL
33136-1002
US

IV. Provider business mailing address

14117 SW 66TH ST APT H8
MIAMI FL
33183-2277
US

V. Phone/Fax

Practice location:
  • Phone: 786-439-9212
  • Fax:
Mailing address:
  • Phone: 786-439-9212
  • Fax: 786-439-9212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberPS67511
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: