Provider Demographics
NPI:1720457740
Name:MIAMI COAST PHARMACY LLC
Entity Type:Organization
Organization Name:MIAMI COAST PHARMACY LLC
Other - Org Name:MIAMI COAST PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALPESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-615-8627
Mailing Address - Street 1:1250 NW 7TH ST
Mailing Address - Street 2:UNIT 101-102
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125
Mailing Address - Country:US
Mailing Address - Phone:786-615-8627
Mailing Address - Fax:786-762-2814
Practice Address - Street 1:1250 NW 7TH ST UNIT 101-102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3744
Practice Address - Country:US
Practice Address - Phone:786-615-8627
Practice Address - Fax:786-762-2814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-21
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WD0400X, 333600000X
FLPH293863336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Multi-Specialty
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2154124OtherPK
FL016116400Medicaid