Organization
ST. JOHNS DRUG STORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FELIPE RODRIGUEZ (PRESIDENT)
(305) 261-0066
Entity
Organization
Contact information
Practice address
5633 SW 8 ST, MIAMI, FL 33134
(305) 261-0066
(305) 261-0076
Mailing address
5633 SW 8 ST, MIAMI, FL 33134
(305) 261-0066
(305) 261-0076
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PH19483
FL
332BX2000X
Oxygen Equipment & Supplies (DME)
PH19483
FL
3336C0003X
Community/Retail Pharmacy
Primary
PH19483
FL
Other
Enumeration date
10/04/2006
Last updated
11/20/2007
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