Provider Demographics
NPI:1184106668
Name:SMP PHARMACY SOLUTIONS #3, LLC
Entity type:Organization
Organization Name:SMP PHARMACY SOLUTIONS #3, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:BARDISA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:855-208-8358
Mailing Address - Street 1:6050 S DIXIE HWY STE 201
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5046
Mailing Address - Country:US
Mailing Address - Phone:855-208-8358
Mailing Address - Fax:888-971-3822
Practice Address - Street 1:6050 S DIXIE HWY STE 201
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5046
Practice Address - Country:US
Practice Address - Phone:855-208-8358
Practice Address - Fax:888-971-3822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH316303336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH31630OtherFLORIDA BOARD OF PHARMACY