Healthcare Provider Details

I. General information

NPI: 1346407731
Provider Name (Legal Business Name): I.C.F. ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 04/15/2022
Certification Date: 04/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2295 NW 28TH ST
MIAMI FL
33142-5987
US

IV. Provider business mailing address

2295 NW 28TH ST
MIAMI FL
33142-5987
US

V. Phone/Fax

Practice location:
  • Phone: 305-635-2358
  • Fax: 305-635-2376
Mailing address:
  • Phone: 305-635-2358
  • Fax: 305-635-2376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH23368
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ZOILA VALDES
Title or Position: PRESIDENT
Credential:
Phone: 305-635-2358