Healthcare Provider Details

I. General information

NPI: 1144555467
Provider Name (Legal Business Name): PHARMALIFE CONSULTANT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 02/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 SW 1ST ST
MIAMI FL
33130-1207
US

IV. Provider business mailing address

PO BOX 431258
MIAMI FL
33243-1258
US

V. Phone/Fax

Practice location:
  • Phone: 305-545-5586
  • Fax: 305-545-5587
Mailing address:
  • Phone: 305-545-5586
  • Fax: 305-545-5587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number25182
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ALBERTO DORADO
Title or Position: PRESIDENT
Credential:
Phone: 305-545-5586