Provider Demographics
NPI:1942237870
Name:IZZ AND SONS INC
Entity Type:Organization
Organization Name:IZZ AND SONS INC
Other - Org Name:ROBERTS DRUGSTORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:AIMAU
Authorized Official - Middle Name:
Authorized Official - Last Name:ARYAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-545-0533
Mailing Address - Street 1:3454 NW 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33127-3306
Mailing Address - Country:US
Mailing Address - Phone:305-633-0606
Mailing Address - Fax:305-633-4791
Practice Address - Street 1:3454 NW 7TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-3306
Practice Address - Country:US
Practice Address - Phone:305-633-0606
Practice Address - Fax:305-633-4791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
FLPH170423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021908801Medicaid
1088322OtherNCPDP PROVIDER IDENTIFICATION NUMBER
FL021908801Medicaid