Organization Name: | CENTRO MEDICO FAMILIAR BUEN PASTOR PHARMACY |
NPI Number: | 1528468956 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GABRIEL G FLOREZ (PRES) |
Mailing Address: | 4440 Sheridan St Ste C Hollywood |
State: | FL US |
Postal Code: | 330213535 |
Phone Number: | 9548820191 |
Fax Number: | 7542103962 |
NPI Enumeration Date: | 09/04/2014 |
NPI Last Update Date: | 09/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ACN 285 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |