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General NPI Number Information
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NPI Number | 1467862540
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Entity Type | Organization
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Legal Business Name | NUESTRA PHARMACY AND DISCOUNT, CORP.
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Dates
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Enumeration Date | 04/29/2014
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Last Update Date | 04/29/2014
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Provider Practice Location Address
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Address Line | 1208 SW 2ND ST
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City | MIAMI
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State | FL
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Zip | 33135-2404
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Country | US
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Telephone | 305-418-0052
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Fax | 786-420-2881
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Provider Business Mailing Address
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Address Line | 1208 SW 2ND ST
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City | MIAMI
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State | FL
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Zip | 33135-2404
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Country | US
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Telephone | 305-418-0052
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Fax | 786-420-2881
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Authorized Official
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Title or Position | OWNER
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Name | CARLOS E CARDENAS
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Credential |
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Telephone | 305-418-0052
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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 | PH28085
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License Number State | FL
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