| NPI | 1508107418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SADIEL BASULTO President 786-294-0570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH24668) |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2013-03-04 |