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General NPI Number Information
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NPI Number | 1447626650
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Entity Type | Individual
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Provider Name | CECILY EDMOND
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Gender | Female
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Dates
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Enumeration Date | 08/11/2015
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Last Update Date | 07/22/2016
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Provider Practice Location Address
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Address Line | 1051 NE 139TH ST
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City | NORTH MIAMI
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State | FL
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Zip | 33161-3339
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Country | US
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Telephone | 305-877-7066
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Fax |
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Provider Business Mailing Address
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Address Line | 1611 N.W. 12TH AVENUE 33136
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City | MIAMI
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State | FL
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Zip | 33136-3339
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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 |
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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 | PS53790
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License Number State | FL
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