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NPI Code Detail

MEDICARE: ELSA JACQUELINE ALONSO-ROTH PHARMACIST

MEDICARE: ELSA JACQUELINE ALONSO-ROTH PHARMACIST
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
1183500000XPharmacistPS23582FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PS23582OTHERFLNABP

General Provider Information

NPI Number : 1780289520
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELSA JACQUELINE ALONSO-ROTH PHARMACIST
Provider Business Mailing Address
First Line : 4000 ESTEPONA AVE
Second Line :
City : DORAL
State : FL
Zip : 33178-2927
Country : US
Telephone Number : 305-554-1121
Fax Number : 305-554-9032
Provider Business Practice Location Address
First Line : 13830 SW 8TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33184-3033
Country : US
Telephone Number : 305-554-1121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2020
Last Update Date : 12/01/2020

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Directions to “ ELSA JACQUELINE ALONSO-ROTH PHARMACIST” Practice Location

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