Provider Demographics
NPI:1417668328
Name:SEQUEIRA, GUNTHER (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:GUNTHER
Middle Name:
Last Name:SEQUEIRA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9931 W FLAGLER ST APT 431
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1865
Mailing Address - Country:US
Mailing Address - Phone:786-281-6376
Mailing Address - Fax:
Practice Address - Street 1:2400 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-4516
Practice Address - Country:US
Practice Address - Phone:305-764-3780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49771183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist