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General NPI Number Information
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NPI Number | 1407748320
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Entity Type | Organization
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Legal Business Name | TAQUECHEL PHARMACY RX LLC
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 20920 W DIXIE HWY
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City | AVENTURA
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State | FL
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Zip | 33180
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Country | US
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Telephone | 305-974-5604
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Fax |
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Provider Business Mailing Address
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Address Line | 20920 W DIXIE HWY
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City | AVENTURA
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State | FL
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Zip | 33180
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Country | US
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Telephone | 305-974-5604
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID IBRAGIMOV
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Credential |
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Telephone | 702-372-1579
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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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