Provider Demographics
NPI:1184303224
Name:ECHAGUE ALAMO, OMAR
Entity type:Individual
Prefix:
First Name:OMAR
Middle Name:
Last Name:ECHAGUE ALAMO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8728 NW 116TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1971
Mailing Address - Country:US
Mailing Address - Phone:786-831-1667
Mailing Address - Fax:
Practice Address - Street 1:3750 NW 87TH AVE UNIT B
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4670
Practice Address - Country:US
Practice Address - Phone:178-633-1820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS65836183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist