Healthcare Provider Details

I. General information

NPI: 1164346169
Provider Name (Legal Business Name): CHRISTAL DONALDSON RPT,CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14311 SW 105TH AVE
MIAMI FL
33176-7018
US

IV. Provider business mailing address

14311 SW 105TH AVE
MIAMI FL
33176-7018
US

V. Phone/Fax

Practice location:
  • Phone: 786-333-0920
  • Fax: 305-355-2296
Mailing address:
  • Phone: 786-333-0920
  • Fax: 305-355-2296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberRPT10178265
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: