Provider Demographics
NPI:1922688787
Name:BALLADARES, ANA MARIA (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:MARIA
Last Name:BALLADARES
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10404 W FLAGLER ST STE 20-21
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1615
Mailing Address - Country:US
Mailing Address - Phone:305-223-2324
Mailing Address - Fax:305-223-6028
Practice Address - Street 1:10404 W FLAGLER ST STE 20-21
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1615
Practice Address - Country:US
Practice Address - Phone:305-223-2324
Practice Address - Fax:305-223-6028
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS33361183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist