Provider Demographics
NPI:1801197132
Name:CAREMED PHARMACY LLC
Entity Type:Organization
Organization Name:CAREMED PHARMACY LLC
Other - Org Name:CAREMAX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:DE SOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-455-1250
Mailing Address - Street 1:15450 NEW BARN RD STE 105
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2169
Mailing Address - Country:US
Mailing Address - Phone:305-455-1250
Mailing Address - Fax:305-455-1255
Practice Address - Street 1:15450 NEW BARN RD STE 105
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2169
Practice Address - Country:US
Practice Address - Phone:305-455-1250
Practice Address - Fax:305-455-1255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-03
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0002X
FLPH250873336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114559200Medicaid
FL023321600Medicaid