Provider Demographics
NPI:1417239112
Name:DRUBI, GRACIELA (R PH)
Entity Type:Individual
Prefix:MRS
First Name:GRACIELA
Middle Name:
Last Name:DRUBI
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 NE 186TH DR
Mailing Address - Street 2:
Mailing Address - City:N MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4387
Mailing Address - Country:US
Mailing Address - Phone:786-252-2425
Mailing Address - Fax:305-893-9415
Practice Address - Street 1:12395 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2722
Practice Address - Country:US
Practice Address - Phone:305-893-6860
Practice Address - Fax:305-893-9415
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40969183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist