Provider Demographics
NPI:1720464811
Name:MY FAMILY PHARMACY & DISCOUNT, LLC
Entity Type:Organization
Organization Name:MY FAMILY PHARMACY & DISCOUNT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:CORTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-200-5973
Mailing Address - Street 1:8410 W FLAGLER ST
Mailing Address - Street 2:SUITE 105-B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2092
Mailing Address - Country:US
Mailing Address - Phone:305-200-5973
Mailing Address - Fax:305-603-8534
Practice Address - Street 1:8410 W FLAGLER ST
Practice Address - Street 2:SUITE 105-B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2092
Practice Address - Country:US
Practice Address - Phone:305-200-5973
Practice Address - Fax:305-603-8534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH255913336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004318700Medicaid
FL1881972479OtherNPI
FL1881972479OtherNPI
FLGD223AMedicare Oscar/Certification