| NPI | 1770924789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CHEN Authorized Official 305-831-4722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2025-02-20 |