Provider Demographics
NPI:1417080250
Name:CANDIA, ISOLINA AMPARO (RPH)
Entity Type:Individual
Prefix:
First Name:ISOLINA
Middle Name:AMPARO
Last Name:CANDIA
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 1:15253 SW 39 TERRACE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185
Mailing Address - Country:US
Mailing Address - Phone:305-226-8810
Mailing Address - Fax:
Practice Address - Street 1:505 SW 8 ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3413
Practice Address - Country:US
Practice Address - Phone:305-856-2211
Practice Address - Fax:305-856-5682
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS16905183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist