Organization Active NPI

Atlantis Pharmacy Inc

  • Community/Retail Pharmacy
  • Miami, FL
National Provider Identifier
1114095908
Registry record updated Mar 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH20984 Issued in FL
Legal business name
ATLANTIS PHARMACY INC
Practice address
136 NW 57 Ave
Miami, FL 33126
Phone
(305) 265-0001
Fax
(305) 265-0050
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Yanet Rodriguez Clavero
Title
President Owner
Phone
(305) 265-0001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PH20984 FL Primary

Addresses

Primary practice location

136 NW 57 Ave
Miami, FL 33126

Mailing address

136 NW 57 Ave
Miami, FL 33126
Phone (305) 265-0001

Other identifiers 1

IdentifierTypeStateIssuer
032179600MedicaidFL

National Provider Directory

National Provider Directory

Locations

136 NW 57th Ave
Miami, FL 33126
Phone (305) 265-0001

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362441600000",
    "number": "1114095908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 NW 57 AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33126",
            "telephone_number": "305-265-0001",
            "fax_number": "305-265-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 NW 57 AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33126",
            "telephone_number": "305-265-0001",
            "fax_number": "305-265-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2013-03-05",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ CLAVERO",
        "authorized_official_first_name": "YANET",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "305-265-0001"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH20984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032179600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.