Provider Demographics
NPI:1467539130
Name:CND3 INC
Entity Type:Organization
Organization Name:CND3 INC
Other - Org Name:ROBALO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NIRAV
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-844-1191
Mailing Address - Street 1:228 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-3552
Mailing Address - Country:US
Mailing Address - Phone:561-844-1191
Mailing Address - Fax:561-842-1588
Practice Address - Street 1:228 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-3552
Practice Address - Country:US
Practice Address - Phone:561-844-1191
Practice Address - Fax:561-842-1588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH243233336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2123189OtherPK
FL001686800Medicaid
FL001686801Medicaid