Organization
HERSEN INC
Active
Other names
SAN JOSE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
YAILKA FRAGA (PRES)
(305) 266-1234
Entity
Organization
Contact information
Practice address
2666 SW 87TH AVE, MIAMI, FL 33165-2031
(305) 229-1300
(305) 229-1532
Mailing address
2666 SW 87TH AVE, MIAMI, FL 33165-2031
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH0015272
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1064764
OTHER ID NUMBER
—
Enumeration date
08/29/2006
Last updated
02/01/2008
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