Provider Demographics
NPI:1659968048
Name:AQUINO, LIZBET (RPH)
Entity Type:Individual
Prefix:
First Name:LIZBET
Middle Name:
Last Name:AQUINO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9057 SW 167TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-4817
Mailing Address - Country:US
Mailing Address - Phone:954-859-0211
Mailing Address - Fax:
Practice Address - Street 1:10720 SW 72ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2702
Practice Address - Country:US
Practice Address - Phone:305-271-9909
Practice Address - Fax:305-412-1851
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS52933183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL52933OtherPHARMACIST