Provider Demographics
NPI:1528187044
Name:DE HOSTOS, CARLOS E (RPH)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:E
Last Name:DE HOSTOS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 SW 156TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-4909
Mailing Address - Country:US
Mailing Address - Phone:305-227-3226
Mailing Address - Fax:
Practice Address - Street 1:2740 SW 156TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-4909
Practice Address - Country:US
Practice Address - Phone:305-227-3226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS31549183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist