Healthcare Provider Details

I. General information

NPI: 1255256400
Provider Name (Legal Business Name): GLA PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 NW 7TH ST STE 1
MIAMI FL
33126-2252
US

IV. Provider business mailing address

4700 NW 7TH ST STE 1
MIAMI FL
33126-2252
US

V. Phone/Fax

Practice location:
  • Phone: 305-640-5764
  • Fax: 786-925-7436
Mailing address:
  • Phone:
  • Fax: 786-925-7436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GLEYVYS RODRIGUEZ
Title or Position: PHARMACIST
Credential: PHARMD
Phone: 305-640-5764