Organization
LOS PALACIOS MEDICAL SUPPLIES AND PHARMACY
Active
Other names
LOS PALACIOS MEDICAL SUPPLIES INC, LOS PALACIOS MEDICAL SUPPLIES AND PHARMACY, LOS PALACIOS MEDICAL SUPPLIES, INC, LOS PALACIOS MEDICAL SUPPLIES & Pharmacy, PRIME CARE SALUD NOVA PHARMACY, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ELOINA CARBALLO (OWNER)
(305) 688-0644
Entity
Organization
Contact information
Practice address
4213 E 4TH AVE, HIALEAH, FL 33013-2305
(305) 688-0644
(305) 688-0662
Mailing address
4213 E 4TH AVE, HIALEAH, FL 33013-2305
(305) 688-0644
(305) 688-0662
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PH23304
FL
3336C0003X
Community/Retail Pharmacy
Primary
PH23304
FL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008158300
—
FL
05
—
117627900
—
FL
01
—
2011367
PK
—
Enumeration date
07/10/2006
Last updated
02/02/2026
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