Organization
AVALON PHARMACY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELSA ZAMORA (PRESIDENT)
(305) 740-5336
Entity
Organization
Contact information
Practice address
4993 SW 74TH CT, SUITE A, MIAMI, FL 33155-4471
(305) 740-5336
(305) 740-5337
Mailing address
4993 SW 74TH CT, SUITE A, MIAMI, FL 33155-4471
(305) 740-5336
(305) 740-5337
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1056
DOC NUMB
FL
Enumeration date
06/14/2012
Last updated
06/14/2012
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