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General NPI Number Information
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NPI Number | 1184103111
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Entity Type | Organization
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Legal Business Name | NIEVES PHARMACY, LLC
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Dates
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Enumeration Date | 08/10/2018
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Last Update Date | 08/10/2018
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Provider Practice Location Address
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Address Line | 1140 W 50TH ST STE 207
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City | HIALEAH
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State | FL
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Zip | 33012-3438
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Country | US
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Telephone | 786-540-2363
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Fax | 305-456-3070
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Provider Business Mailing Address
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Address Line | 1140 W 50TH ST STE 207
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City | HIALEAH
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State | FL
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Zip | 33012-3438
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Country | US
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Telephone | 786-540-2363
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Fax | 305-456-3070
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Authorized Official
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Title or Position | OWNER
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Name | TERESA RIVERO
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Credential |
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Telephone | 786-972-0392
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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 | FL
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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 |
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License Number State | FL
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