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General NPI Number Information
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NPI Number | 1528240736
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL PHARMACY SERVICES AND DME INC.
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 05/29/2008
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Provider Practice Location Address
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Address Line | 10993 SW 186TH ST
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City | MIAMI
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State | FL
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Zip | 33157-6812
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Country | US
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Telephone | 305-253-6634
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Fax | 305-253-6635
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Provider Business Mailing Address
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Address Line | 10993 SW 186TH ST
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City | MIAMI
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State | FL
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Zip | 33157-6812
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Country | US
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Telephone | 305-253-6634
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Fax | 305-253-6635
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. PEDRO PABLO ROGES
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Credential | PHARM.D.
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Telephone | 305-505-7486
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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 | PH23089
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License Number State | FL
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