MEDICARE: RODRIGUEZ PHARMACY CORP

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		FL

General Provider Information

NPI Number	:	1851709927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RODRIGUEZ PHARMACY CORP

Provider Business Mailing Address
First Line	:	6600 W FLAGLER ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2922
Country	:	US
Telephone Number	:	305-640-5097
Fax Number	:	305-640-5258

Provider Business Practice Location Address
First Line	:	6600 W FLAGLER ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2922
Country	:	US
Telephone Number	:	305-640-5097
Fax Number	:	305-640-5258

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALIAN MIRANDA
Credential	:
Telephone Number	:	305-640-5097

Provider Enumeration Date	:	08/01/2014
Last Update Date	:	12/08/2016

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