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General NPI Number Information
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NPI Number | 1063292142
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Entity Type | Individual
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Provider Name | MIZNELLE ZOREILY VEGA-ORTIZ PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/05/2023
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 871 W OAKLAND PARK BLVD
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City | WILTON MANORS
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State | FL
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Zip | 33311-1731
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Country | US
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Telephone | 954-233-2121
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Fax |
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Provider Business Mailing Address
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Address Line | 11851 SW 42ND PL UNIT 314
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City | MIRAMAR
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State | FL
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Zip | 33025-8071
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Country | US
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Telephone | 939-579-0576
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 66454
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License Number State | FL
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