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General NPI Number Information
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NPI Number | 1851791339
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Entity Type | Organization
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Legal Business Name | MEDICA PHARMACY & COMPOUNDING
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Dates
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Enumeration Date | 09/03/2014
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Last Update Date | 04/13/2015
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Provider Practice Location Address
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Address Line | 21004 W DIXIE HWY
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City | AVENTURA
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State | FL
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Zip | 33180-1132
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Country | US
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Telephone | 305-570-1933
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Fax |
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Provider Business Mailing Address
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Address Line | 21004 W DIXIE HWY
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City | AVENTURA
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State | FL
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Zip | 33180-1132
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Country | US
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Telephone | 305-570-1933
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOCELYN BIEN-AIME
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Credential |
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Telephone | 954-655-4552
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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 | PH 28460
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License Number State | FL
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