Provider Demographics
NPI:1114529369
Name:FIGUEREDO, ODALYS (RPH)
Entity Type:Individual
Prefix:MS
First Name:ODALYS
Middle Name:
Last Name:FIGUEREDO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15980 SW 42ND TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-3831
Mailing Address - Country:US
Mailing Address - Phone:305-401-2268
Mailing Address - Fax:
Practice Address - Street 1:8400 CORAL WAY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2334
Practice Address - Country:US
Practice Address - Phone:305-351-9519
Practice Address - Fax:305-225-2225
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS26454183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist