Provider Demographics
NPI:1295005221
Name:FLORIDA PHARMACY & DISCOUNT CORP
Entity Type:Organization
Organization Name:FLORIDA PHARMACY & DISCOUNT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AILIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-631-6799
Mailing Address - Street 1:2422 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-3004
Mailing Address - Country:US
Mailing Address - Phone:305-631-6799
Mailing Address - Fax:305-631-6799
Practice Address - Street 1:2422 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-3004
Practice Address - Country:US
Practice Address - Phone:305-631-6799
Practice Address - Fax:305-631-6799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1657OtherNUMB