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General NPI Number Information
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NPI Number | 1659624534
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Entity Type | Organization
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Legal Business Name | MEDPLUS PHARMACY
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Dates
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Enumeration Date | 10/17/2012
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Last Update Date | 07/08/2014
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Provider Practice Location Address
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Address Line | 13016 SW 120TH ST
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City | MIAMI
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State | FL
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Zip | 33186-4526
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Country | US
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Telephone | 305-969-4435
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Fax | 305-969-4437
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Provider Business Mailing Address
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Address Line | 13016 SW 120TH ST
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City | MIAMI
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State | FL
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Zip | 33186-4526
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Country | US
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Telephone | 305-969-4435
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Fax | 305-969-4437
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NICHOLAS A BORGESANO
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Credential |
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Telephone | 786-344-8916
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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 | PH26365
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License Number State | FL
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