Organization
LA MILAGROSA PHARMACY & DISCOUNT LLC
Active
Other names
LA MILAGROSA PHARMACY & DISCOUNT
Organization subpart
No
Provider details
NPI number
Authorized official
MARICELA NICOLAS (PRESIDENT/OWNER)
(305) 545-1127
Entity
Organization
Contact information
Practice address
432 SW 8TH AVE, MIAMI, FL 33130-2507
(305) 545-1127
(305) 545-1129
Mailing address
432 SW 8TH AVE, MIAMI, FL 33130-2507
(305) 545-1127
(305) 545-1129
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH23391
FL
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000362100
—
FL
01
—
2011854
PK
—
Enumeration date
05/29/2008
Last updated
04/21/2016
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