Provider Demographics
NPI:1144241100
Name:NUTRA PHARM LLC
Entity Type:Organization
Organization Name:NUTRA PHARM LLC
Other - Org Name:SOLUTIONS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELKIN
Authorized Official - Suffix:
Authorized Official - Credentials:NATUROPATHY
Authorized Official - Phone:305-945-8477
Mailing Address - Street 1:17036 COLLINS AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3642
Mailing Address - Country:US
Mailing Address - Phone:305-945-8977
Mailing Address - Fax:305-947-7725
Practice Address - Street 1:17036 COLLINS AVE
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-3642
Practice Address - Country:US
Practice Address - Phone:305-945-8977
Practice Address - Fax:305-947-7725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH210473336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2013875OtherPK
FL5373540001Medicaid