Provider Demographics
NPI:1790068252
Name:DELAOSA, EYLEEN CARIDAD (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:EYLEEN
Middle Name:CARIDAD
Last Name:DELAOSA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13330 SW 17TH LN APT 3
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-7611
Mailing Address - Country:US
Mailing Address - Phone:305-905-2363
Mailing Address - Fax:
Practice Address - Street 1:15705 SW 72ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-5069
Practice Address - Country:US
Practice Address - Phone:305-382-6123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS45519183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS45519OtherSTATE LISCENCE