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General NPI Number Information
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NPI Number | 1174767610
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Entity Type | Organization
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Legal Business Name | NOVA PHARMACY & DISCOUNT
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Dates
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Enumeration Date | 04/28/2009
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Last Update Date | 04/28/2009
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Provider Practice Location Address
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Address Line | 8216 W FLAGLER ST
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City | MIAMI
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State | FL
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Zip | 33144
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Country | US
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Telephone | 305-207-7050
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Fax | 305-207-7052
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Provider Business Mailing Address
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Address Line | 8216 W FLAGLER ST
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City | MIAMI
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State | FL
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Zip | 33144-2028
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Country | US
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Telephone | 305-207-7050
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Fax | 305-207-7052
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MANUEL ALFONSO JR.
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Credential |
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Telephone | 305-207-7050
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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 | PH24036
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License Number State | FL
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