Healthcare Provider Details

I. General information

NPI: 1861361602
Provider Name (Legal Business Name): MICCOSUKEE HEALTH CENTER PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2025
Last Update Date: 10/31/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37790 SW 8TH STREET
MIAMI FL
33194
US

IV. Provider business mailing address

37790 SW 8TH STREET MICCOSUKEE HEALTH CLINIC PHARMACY
MIAMI FL
33194
US

V. Phone/Fax

Practice location:
  • Phone: 305-894-2387
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ALINA GARCIA-SIGOENKO
Title or Position: PHARMACY MANAGER
Credential: PHARMD
Phone: 305-894-2387