Provider Demographics
NPI:1477832301
Name:SOUTH FLORIDA PHARMACY SERVICES LLC
Entity Type:Organization
Organization Name:SOUTH FLORIDA PHARMACY SERVICES LLC
Other - Org Name:SOUTH FLORIDA PHARMACY SERVICES, LLC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YAMILET
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-887-6868
Mailing Address - Street 1:1475 W OKEECHOBEE RD STE 5
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-2860
Mailing Address - Country:US
Mailing Address - Phone:305-887-6868
Mailing Address - Fax:305-887-6869
Practice Address - Street 1:1475 W OKEECHOBEE RD STE 5
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-2860
Practice Address - Country:US
Practice Address - Phone:305-887-6868
Practice Address - Fax:305-887-6869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-09
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH 256963336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5708978OtherNCPDP PROVIDER IDENTIFICATION NUMBER