Provider Demographics
NPI:1013209295
Name:PHARMALIFE #2, INC.
Entity Type:Organization
Organization Name:PHARMALIFE #2, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:DORADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-668-6684
Mailing Address - Street 1:4443 NW 2ND AVENUE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33127
Mailing Address - Country:US
Mailing Address - Phone:305-572-9210
Mailing Address - Fax:305-572-9260
Practice Address - Street 1:4443 NW 2 AVENUE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127
Practice Address - Country:US
Practice Address - Phone:305-572-9210
Practice Address - Fax:305-572-9260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-06
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH254103336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy