Provider Demographics
NPI:1689604621
Name:MABELEX INC D/BA/ INTERNATIONAL GARDENS PHARMACY
Entity Type:Organization
Organization Name:MABELEX INC D/BA/ INTERNATIONAL GARDENS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AULET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-553-6327
Mailing Address - Street 1:12610 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-1424
Mailing Address - Country:US
Mailing Address - Phone:305-553-6327
Mailing Address - Fax:305-553-6331
Practice Address - Street 1:12610 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1424
Practice Address - Country:US
Practice Address - Phone:305-553-6327
Practice Address - Fax:305-553-6331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1247890001Medicare ID - Type UnspecifiedPROVIDER