Healthcare Provider Details

I. General information

NPI: 1861709008
Provider Name (Legal Business Name): RYCHIMENDI CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2010
Last Update Date: 08/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8216 W FLAGLER ST
MIAMI FL
33144-2028
US

IV. Provider business mailing address

8216 W FLAGLER ST
MIAMI FL
33144-2028
US

V. Phone/Fax

Practice location:
  • Phone: 305-223-0784
  • Fax: 305-223-0786
Mailing address:
  • Phone: 305-223-0784
  • Fax: 305-223-0786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH24861
License Number StateFL

VIII. Authorized Official

Name: RAQUEL LEYVA
Title or Position: OWNER
Credential:
Phone: 305-223-0784