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General NPI Number Information
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NPI Number | 1316590987
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Entity Type | Organization
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Legal Business Name | GLS PHARMACY LLC
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Dates
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Enumeration Date | 07/22/2019
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Last Update Date | 07/22/2019
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Provider Practice Location Address
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Address Line | 15680 SW 72ND ST
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City | MIAMI
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State | FL
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Zip | 33193-1923
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Country | US
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Telephone | 786-391-3636
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Fax | 786-391-3701
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Provider Business Mailing Address
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Address Line | 15680 SW 72ND ST
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City | MIAMI
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State | FL
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Zip | 33193-1923
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Country | US
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Telephone | 786-391-3636
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Fax | 786-391-3701
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Authorized Official
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Title or Position | PDM/OWNER
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Name | ISIS ISEL HERNANDEZ
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Credential | PHARMD
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Telephone | 786-391-3636
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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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