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General NPI Number Information
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NPI Number | 1881961282
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Entity Type | Organization
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Legal Business Name | BIOMAX PHARMACY, LLC
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Dates
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Enumeration Date | 11/29/2011
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Last Update Date | 05/31/2013
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Provider Practice Location Address
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Address Line | 14285 SW 42ND ST SUITE 212
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City | MIAMI
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State | FL
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Zip | 33175-6410
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Country | US
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Telephone | 786-334-5155
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Fax | 786-221-2553
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Provider Business Mailing Address
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Address Line | 14285 SW 42ND ST SUITE 212
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City | MIAMI
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State | FL
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Zip | 33175-6410
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Country | US
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Telephone | 786-334-5155
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Fax | 786-221-2553
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. TAMARA ESPONDA
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Credential |
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Telephone | 786-334-5155
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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 | PH25804
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License Number State | FL
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