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General NPI Number Information
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NPI Number | 1427560630
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Entity Type | Organization
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Legal Business Name | AGV SPECIALTY PHARMACY
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Dates
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Enumeration Date | 10/27/2017
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 3774 W 12TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-4126
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Country | US
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Telephone | 786-334-5283
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Fax |
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Provider Business Mailing Address
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Address Line | 486 PALM AVE
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City | HIALEAH
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State | FL
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Zip | 33010-4718
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | ARIEL D GUERRA
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Credential |
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Telephone | 786-269-5888
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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 | PH31005
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License Number State | FL
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