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General NPI Number Information
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NPI Number | 1962125922
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Entity Type | Individual
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Provider Name | JUAN ANDRES FERNANDEZ BLAZQUEZ PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/23/2022
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 13675 SW 88TH ST
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City | MIAMI
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State | FL
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Zip | 33186-1324
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Country | US
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Telephone | 305-385-1035
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 SW 37TH AVE APT 1407
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City | MIAMI
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State | FL
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Zip | 33145-1157
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Country | US
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Telephone | 305-586-5808
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS63542
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License Number State | FL
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