Provider Demographics
NPI:1710478755
Name:EASYSCRIPTS CUTLER BAY LLC
Entity Type:Organization
Organization Name:EASYSCRIPTS CUTLER BAY LLC
Other - Org Name:EASYSCRIPTS CUTLER BAY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GERSTENKORN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:786-495-6409
Mailing Address - Street 1:9250 W FLAGLER STREET, STE 600
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174
Mailing Address - Country:US
Mailing Address - Phone:305-448-8100
Mailing Address - Fax:
Practice Address - Street 1:19177 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-7714
Practice Address - Country:US
Practice Address - Phone:305-537-3287
Practice Address - Fax:844-822-0151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-25
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH313663336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2177277OtherPK
FLPH31366OtherFLORIDA BOARD OF PHARMACY