Organization
GAVIOTA PHARMACY DISCOUNT CORP
Active
Organization
GAVIOTA PHARMACY DISCOUNT CORP
Active
Other names
Gaviota Pharmacy Discount Corp
Organization subpart
No
Provider details
NPI number
Authorized official
ODALYS SANTANA (OWNER)
(305) 223-6469
Entity
Organization
Contact information
Practice address
10521 SW 40TTH STREET, MIAMI, FL 33165-3747
(305) 223-6469
(305) 223-6479
Mailing address
10521 SW 40TTH STREET, MIAMI, FL 33165-3747
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH23661
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1041475
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/29/2008
Last updated
03/16/2009
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