Healthcare Provider Details

I. General information

NPI: 1871987271
Provider Name (Legal Business Name): URANTIA PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2015
Last Update Date: 10/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 SW 8TH ST
MIAMI FL
33135-2861
US

IV. Provider business mailing address

2901 SW 8TH ST
MIAMI FL
33135-2861
US

V. Phone/Fax

Practice location:
  • Phone: 786-717-5759
  • Fax: 786-717-6302
Mailing address:
  • Phone: 786-717-5759
  • Fax: 786-717-6302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH28823
License Number StateFL

VIII. Authorized Official

Name: URBANO RODRIGUEZ
Title or Position: PRESIDENT
Credential:
Phone: 786-717-5759