Organization
YOUTH PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAXIMO E GUILLEN (PRESIDENT)
(305) 220-2848
Entity
Organization
Contact information
Practice address
10788 SW 24TH ST, MIAMI, FL 33165-2499
(305) 220-2848
(305) 220-2849
Mailing address
10788 SW 24TH ST, MIAMI, FL 33165-2499
(305) 220-2848
(305) 220-2849
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH25480
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25480
FLA
FL
Enumeration date
06/10/2011
Last updated
02/25/2013
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