Provider Demographics
NPI:1255325544
Name:TIRADO, WILMER (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:WILMER
Middle Name:
Last Name:TIRADO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9374 SW 173RD TER
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-5724
Mailing Address - Country:US
Mailing Address - Phone:305-213-9241
Mailing Address - Fax:
Practice Address - Street 1:9374 SW 173RD TER
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-5724
Practice Address - Country:US
Practice Address - Phone:305-213-9241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-01
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051844183500000X
PR4921183500000X
WVRP0008073183500000X
PARP450079183500000X
MAPH235789183500000X
FLNP3051835N0905X
PR0061835N0905X
FLPS35519183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835N0905XPharmacy Service ProvidersPharmacistNuclear