Provider Demographics
NPI:1033124425
Name:LEOMELI INVESTMENTS CORP
Entity Type:Organization
Organization Name:LEOMELI INVESTMENTS CORP
Other - Org Name:DORAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DARIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDEZ BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-471-4813
Mailing Address - Street 1:5211 NW 79TH AVE
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4715
Mailing Address - Country:US
Mailing Address - Phone:305-471-4813
Mailing Address - Fax:305-417-4816
Practice Address - Street 1:5211 NW 79TH AVE
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-4715
Practice Address - Country:US
Practice Address - Phone:305-471-4813
Practice Address - Fax:305-417-4816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5706340001Medicare NSC