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General NPI Number Information
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NPI Number | 1699801845
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Entity Type | Organization
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Legal Business Name | LUPER CORP
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Dates
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Enumeration Date | 02/24/2007
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Last Update Date | 07/28/2023
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Provider Practice Location Address
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Address Line | 9258 SW 40TH ST
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City | MIAMI
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State | FL
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Zip | 33165-4151
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Country | US
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Telephone | 305-554-0438
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Fax | 305-553-2197
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Provider Business Mailing Address
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Address Line | 9258 SW 40TH ST
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City | MIAMI
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State | FL
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Zip | 33165-4151
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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 | TREASURER
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Name | LOURDES DEL CARMEN PEREZ
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Credential |
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Telephone | 305-554-0438
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH0012004
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License Number State | FL
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