Organization
REAL PHARMACY INC
Active
Other names
Real Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
YANNIEL GUTIERREZ MIRANDA (PRESIDENT)
(786) 534-5952
Entity
Organization
Contact information
Practice address
455 SW 17TH AVE, MIAMI, FL 33135-3626
(786) 534-5952
(786) 534-7818
Mailing address
455 SW 17TH AVE, MIAMI, FL 33135-3626
(786) 534-5952
(786) 534-7818
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH31510
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH31510
STATE LICENSE
FL
Enumeration date
06/29/2018
Last updated
09/06/2019
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