Provider Demographics
NPI:1891474078
Name:PHARMACY BRASIL LAS AMERICAS PBLA LLC
Entity Type:Organization
Organization Name:PHARMACY BRASIL LAS AMERICAS PBLA LLC
Other - Org Name:BRASIL PHARMACY LAS AMERICAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:A.
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:TORRE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:954-361-8919
Mailing Address - Street 1:1121 S MILITARY TRL # 331
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-7645
Mailing Address - Country:US
Mailing Address - Phone:954-361-8919
Mailing Address - Fax:
Practice Address - Street 1:3925 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-6042
Practice Address - Country:US
Practice Address - Phone:954-361-8919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy