Provider Demographics
NPI:1275535965
Name:PICHARDO, ROBERTO VALENTIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:VALENTIN
Last Name:PICHARDO
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 1:14481 SW 37TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3787
Mailing Address - Country:US
Mailing Address - Phone:954-431-8196
Mailing Address - Fax:
Practice Address - Street 1:14481 SW 37TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-3787
Practice Address - Country:US
Practice Address - Phone:954-431-8196
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS00023765183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist