1063514891 NPI number — DR. MARGARETH LAROSE PIERRE PHARMACIST

Table of content: DR. MARGARETH LAROSE PIERRE PHARMACIST (NPI 1063514891)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063514891 NPI number — DR. MARGARETH LAROSE PIERRE PHARMACIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PIERRE
Provider First Name:
MARGARETH
Provider Middle Name:
LAROSE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMACIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LAROSE
Provider Other First Name:
MARGARETH
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMACIST
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1063514891
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 NW 12TH AVE
Provider Second Line Business Mailing Address:
SUITE # 1126
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33136-1051
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-325-2675
Provider Business Mailing Address Fax Number:
305-325-3109

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1500 NW 12TH AVE
Provider Second Line Business Practice Location Address:
SUITE # 1126
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33136-1051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-325-2675
Provider Business Practice Location Address Fax Number:
305-325-3109
Provider Enumeration Date:
09/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P1200X , with the licence number:  24038 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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