Healthcare Provider Details
I. General information
NPI: 1366306532
Provider Name (Legal Business Name): SOWAL PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9375 EMERALD COAST PKWY W STE 6
MIRAMAR BEACH FL
32550-7275
US
IV. Provider business mailing address
9375 EMERALD COAST PKWY W STE 6
MIRAMAR BEACH FL
32550-7275
US
V. Phone/Fax
- Phone: 850-797-2711
- Fax:
- Phone: 850-797-2711
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
SONIA
PETRUCCI
Title or Position: OWNER
Credential: PHARMD
Phone: 305-903-1782