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General NPI Number Information
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NPI Number | 1144241100
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Entity Type | Organization
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Legal Business Name | NUTRA PHARM LLC
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 03/01/2017
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Provider Practice Location Address
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Address Line | 17036 COLLINS AVE
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City | SUNNY ISLES BEACH
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State | FL
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Zip | 33160-3642
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Country | US
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Telephone | 305-945-8977
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Fax | 305-947-7725
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Provider Business Mailing Address
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Address Line | 17036 COLLINS AVE
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City | SUNNY ISLES BEACH
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State | FL
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Zip | 33160-3642
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Country | US
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Telephone | 305-945-8977
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Fax | 305-947-7725
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Authorized Official
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Title or Position | OWNER
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Name | KARINA BELKIN
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Credential | NATUROPATHY
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Telephone | 305-945-8477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH21047
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License Number State | FL
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