Provider Demographics
NPI:1326172529
Name:VICENT, MARIA J (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:J
Last Name:VICENT
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 1:5333 COLLINS AVE APT 303
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2511
Mailing Address - Country:US
Mailing Address - Phone:305-867-9723
Mailing Address - Fax:
Practice Address - Street 1:5333 COLLINS AVE APT 303
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2511
Practice Address - Country:US
Practice Address - Phone:305-867-9723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS33962183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist