Organization
COSTA PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA CRUZ PHARMD (PHARMACY DIRECTOR)
(305) 439-0318
Entity
Organization
Contact information
Practice address
4055 NW 97TH AVE STE 110, DORAL, FL 33178-2911
(305) 439-0318
Mailing address
4055 NW 97TH AVE STE 110, DORAL, FL 33178-2911
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
08/17/2023
Last updated
08/17/2023
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