Provider Demographics
NPI:1508273772
Name:WAITHE, RICHARD RODNEY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:RODNEY
Last Name:WAITHE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15106 SW 128TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6399
Mailing Address - Country:US
Mailing Address - Phone:786-245-3771
Mailing Address - Fax:
Practice Address - Street 1:3401 N MIAMI AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-3525
Practice Address - Country:US
Practice Address - Phone:786-437-0165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-18
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS52041183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist