Provider Demographics
NPI:1992860209
Name:UNIVERSITY OF MIAMI STUDENT HEALTH PHARMACY
Entity Type:Organization
Organization Name:UNIVERSITY OF MIAMI STUDENT HEALTH PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MORA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:305-284-5922
Mailing Address - Street 1:5513 MERRICK DR
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33156
Mailing Address - Country:US
Mailing Address - Phone:305-284-4118
Mailing Address - Fax:305-284-4883
Practice Address - Street 1:5513 MERRICK DR
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33156
Practice Address - Country:US
Practice Address - Phone:305-284-5922
Practice Address - Fax:305-284-4883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS016413183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1008499Medicare UPIN