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General NPI Number Information
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NPI Number | 1740480805
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Entity Type | Organization
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Legal Business Name | MED KENDALL CORP
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 16241 SW 88TH ST
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City | MIAMI
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State | FL
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Zip | 33196-4912
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Country | US
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Telephone | 305-408-6053
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Fax | 305-408-6054
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Provider Business Mailing Address
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Address Line | 16241 SW 88TH ST
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City | MIAMI
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State | FL
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Zip | 33196-4912
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Country | US
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Telephone | 305-408-6053
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Fax | 305-408-6054
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. YORDANI NUNEZ
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Credential |
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Telephone | 305-408-6053
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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 | PH22760
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License Number State | FL
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