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General NPI Number Information
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NPI Number | 1992165195
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Entity Type | Individual
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Provider Name | LISETTE ALBA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 03/01/2016
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Last Update Date | 03/01/2016
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Provider Practice Location Address
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Address Line | 20425 OLD CUTLER RD
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City | CUTLER BAY
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State | FL
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Zip | 33189-1833
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Country | US
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Telephone | 305-235-2214
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Fax |
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Provider Business Mailing Address
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Address Line | 21054 SW 88TH PL
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City | CUTLER BAY
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State | FL
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Zip | 33189-3748
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Country | US
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Telephone |
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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 | PS44088
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License Number State | FL
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