MEDICARE: THE CENTRAL PHARMACY MIAMI, 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
1	3336C0003X	Community/Retail Pharmacy	PH29425	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PH29425	OTHER	FL	FLORIDA BOARD OF PHARMACY

General Provider Information

NPI Number	:	1487025599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CENTRAL PHARMACY MIAMI, INC

Provider Business Mailing Address
First Line	:	3526 W FLAGLER ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-1028
Country	:	US
Telephone Number	:	786-499-1410
Fax Number	:

Provider Business Practice Location Address
First Line	:	3526 W FLAGLER ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-1028
Country	:	US
Telephone Number	:	786-499-1410
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YOANDYS PINO
Credential	:
Telephone Number	:	786-499-1410

Provider Enumeration Date	:	10/14/2015
Last Update Date	:	10/14/2015

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