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General NPI Number Information
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NPI Number | 1235244732
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Entity Type | Individual
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Provider Name | MOON M PULIDO PHARM.D., RPH
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Gender | Female
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1835 S PERIMETER RD SUITE # 140
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-7121
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Country | US
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Telephone | 800-558-7710
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Fax | 877-825-3737
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Provider Business Mailing Address
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Address Line | 19449 SW 54TH ST
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City | MIRAMAR
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State | FL
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Zip | 33029-6271
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Country | US
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Telephone | 305-308-2270
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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 | PS36942
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License Number State | FL
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