Provider Demographics
NPI:1376912667
Name:CORTON, ALFREDO (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALFREDO
Middle Name:
Last Name:CORTON
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 1:1721 SW 133RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3455
Mailing Address - Country:US
Mailing Address - Phone:305-218-8125
Mailing Address - Fax:
Practice Address - Street 1:1721 SW 133RD AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-3455
Practice Address - Country:US
Practice Address - Phone:305-218-8125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS54163183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist