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General NPI Number Information
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NPI Number | 1942574801
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Entity Type | Organization
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Legal Business Name | 17TH STREET PHARMACY & DISCOUNT, INC
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Dates
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Enumeration Date | 02/23/2012
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Last Update Date | 02/23/2012
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Provider Practice Location Address
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Address Line | 1691 NW 27TH AVE
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City | MIAMI
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State | FL
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Zip | 33125-2162
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Country | US
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Telephone | 786-362-5997
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Fax | 786-558-8643
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Provider Business Mailing Address
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Address Line | 1691 NW 27TH AVE
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City | MIAMI
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State | FL
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Zip | 33125-2162
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Country | US
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Telephone | 786-362-5997
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Fax | 786-558-8643
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Authorized Official
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Title or Position | REG PHARMACY TECH
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Name | MRS. DAYSI MARIA ZAYAS-ALFONSO
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Credential |
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Telephone | 305-903-6108
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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 |
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License Number State |
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