Organization
SOUTH PARK PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA ALVAREZ (PRESIDENT)
(305) 803-3608
Entity
Organization
Contact information
Practice address
7035 SW 87TH AVE, MIAMI, FL 33173-2505
(305) 271-3081
(305) 271-0226
Mailing address
7035 SW 87TH AVE, MIAMI, FL 33173-2505
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH21931
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1019478
OTHER ID NUMBER
—
Enumeration date
08/10/2006
Last updated
07/03/2008
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