Healthcare Provider Details

I. General information

NPI: 1316182538
Provider Name (Legal Business Name): PRONTO-MED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2008
Last Update Date: 11/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 NE 26TH ST
WILTON MANORS FL
33305-1321
US

IV. Provider business mailing address

1409 NE 26TH ST
WILTON MANORS FL
33305-1321
US

V. Phone/Fax

Practice location:
  • Phone: 954-566-6151
  • Fax: 954-566-6181
Mailing address:
  • Phone: 954-566-6151
  • Fax: 954-566-6181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH25164
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ALPESH PATEL
Title or Position: OWNER
Credential:
Phone: 248-421-8267