Organization
LA MILAGROSA PHARMACY & DISCOUNT, LLC
Active
Other names
La Milagrosa Pharmacy & Discount, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MARICELA NICOLAS (PRESIDENT)
(305) 545-1127
Entity
Organization
Contact information
Practice address
1690 NW 19TH TER, MIAMI, FL 33125-1593
(786) 953-7156
(786) 953-7968
Mailing address
1690 NW 19TH TER, MIAMI, FL 33125-1593
(786) 953-7156
(786) 953-7968
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH25465
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5705922
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/23/2011
Last updated
02/28/2013
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