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General NPI Number Information
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NPI Number | 1376957050
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Entity Type | Organization
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Legal Business Name | INTERAMERICAN PHARMACY CORP
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Dates
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Enumeration Date | 06/20/2014
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Last Update Date | 10/23/2014
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Provider Practice Location Address
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Address Line | 6001 NW 153RD ST STE 102
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2447
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Country | US
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Telephone | 305-512-3532
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Fax | 305-512-3533
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Provider Business Mailing Address
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Address Line | 6001 NW 153RD ST STE 102
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2447
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Country | US
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Telephone | 305-512-3532
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Fax | 305-512-3533
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | YOHANDRY RODRIGUEZ
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Credential |
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Telephone | 305-240-7952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH28534
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License Number State | FL
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