Healthcare Provider Details

I. General information

NPI: 1831481027
Provider Name (Legal Business Name): SMP PHARMACY SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2011
Last Update Date: 11/04/2020
Certification Date: 11/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 NW 26TH ST STE 101
MIAMI FL
33122-1414
US

IV. Provider business mailing address

7500 NW 26TH ST # 101
MIAMI FL
33122-1414
US

V. Phone/Fax

Practice location:
  • Phone: 305-740-9696
  • Fax: 305-740-9778
Mailing address:
  • Phone: 305-740-9696
  • Fax: 305-740-9778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH25322
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPH25322
License Number StateFL

VIII. Authorized Official

Name: CARLOS MANUEL GOMEZ
Title or Position: QUALITY AND PROJECT MANAGER
Credential:
Phone: 305-740-9720