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NPI Code Detail

MEDICARE: ANGELIZ PHARMACY DISCOUNT INC

MEDICARE: ANGELIZ PHARMACY DISCOUNT INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacyFL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15428OTHERFLDOC NUMBER

General Provider Information

NPI Number : 1053619478
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANGELIZ PHARMACY DISCOUNT INC
Provider Business Mailing Address
First Line : 5496 W 16TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33012-2105
Country : US
Telephone Number : 305-819-3660
Fax Number : 305-819-3661
Provider Business Practice Location Address
First Line : 5496 W 16TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33012-2105
Country : US
Telephone Number : 305-819-3660
Fax Number : 305-819-3661
Authorized Official
Title or Position : PRESIDENT
Name : YAMILA VAZQUEZ DE LLADO
Credential :
Telephone Number : 786-327-7280
Provider Enumeration Date : 03/09/2011
Last Update Date : 12/03/2014

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Directions to “ANGELIZ PHARMACY DISCOUNT INC ” Practice Location

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