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General NPI Number Information
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NPI Number | 1053594754
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Entity Type | Organization
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Legal Business Name | MORENO PHARMACY AND DISCOUNT INC
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Dates
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Enumeration Date | 12/17/2007
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Last Update Date | 06/13/2011
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Provider Practice Location Address
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Address Line | 7299 W FLAGLER ST
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City | MIAMI
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State | FL
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Zip | 33144-2503
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Country | US
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Telephone | 305-262-4288
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Fax | 305-262-4286
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Provider Business Mailing Address
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Address Line | 7299 W FLAGLER ST
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City | MIAMI
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State | FL
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Zip | 33144-2503
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Country | US
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Telephone | 305-262-4288
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Fax | 305-262-4286
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Authorized Official
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Title or Position | OWNER
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Name | MAYDA MORENO
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Credential |
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Telephone | 305-431-0259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH23215
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License Number State | FL
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