MEDICARE: INCA-NICA

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
1	333600000X	Pharmacy	PH0013232	FL

General Provider Information

NPI Number	:	1376685727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INCA-NICA

Provider Business Mailing Address
First Line	:	2747 SW 27 AVENUE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133
Country	:	US
Telephone Number	:	305-643-5340
Fax Number	:	305-285-0387

Provider Business Practice Location Address
First Line	:	2747 SW 27TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-3049
Country	:	US
Telephone Number	:	305-854-4343
Fax Number	:	305-285-0387

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. MARIA ELENA MARTINEZ
Credential	:
Telephone Number	:	305-854-4343

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	08/22/2020

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Directions to “INCA-NICA ” Practice Location

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