| NPI | 1417968058 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-08-10 |
| Last Updated | 2022-12-12 |
| Authorized Official | Sonia Martinez PRESIDENT Phone: 3056654411 |
| Mailing Address | 6420 Sw 62nd Ave South Miami, FL 33143-3302 United States Phone: (305) 665-4411 | Fax: (305) 663-3258 📍 View Map |
| Primary Practice Address | 6420 Sw 62nd Ave South Miami, FL 33143-3302 United States Phone: (305) 665-4411 | Fax: (305) 663-3258 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | FL | 007260700 | - |
| MEDICAID | FL | 019180600 | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 3336C0003X – Pharmacy, Community/Retail Pharmacy | FL | PH22048 |
| No | 3336C0004X – Pharmacy, Compounding Pharmacy | - | - |
| Yes | 333600000X – Pharmacy | - | - |
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About NPI 1417968058
1492 Pharma Group Corp is an organization registered in the CMS NPPES NPI Registry with NPI number 1417968058. The primary specialty listed is Pharmacy. The organization is located in South Miami, FL. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-08-10. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1417968058?
NPI 1417968058 belongs to 1492 Pharma Group Corp, a Pharmacy in South Miami, FL. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1417968058 active?
The current status of NPI 1417968058 in the NPPES registry is Active. The record was last updated on 2022-12-12.
What specialty is NPI 1417968058?
NPI 1417968058 is classified under the taxonomy Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1417968058?
You can verify NPI 1417968058 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1417968058?
The primary practice address on file for NPI 1417968058 is 6420 Sw 62nd Ave, South Miami, FL 33143-3302. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1417968058 issued?
NPI 1417968058 was first issued (enumerated) on 2006-08-10. The NPPES record was last updated on 2022-12-12.
Practice Location Map
1492 Pharma Group Corp is located at 6420 Sw 62nd Ave, South Miami, FL. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as 1492 Pharma Group Corp. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1417968058. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pharmacy, Community/Retail Pharmacy | PH22048 | FL |