Organization Active NPI

Fontainebleau Discount Pharmacy, Inc.

  • Pharmacist
  • Miami, FL
National Provider Identifier
1124128939
Registry record updated Oct 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH15959 Issued in FL
Legal business name
FONTAINEBLEAU DISCOUNT PHARMACY, INC.
Doing business as
Nu-Mart Discount Pharmacy
Practice address
10690 Fontainebleau Blvd
Miami, FL 33172-3117
Phone
(305) 226-6357
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2008

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

Authorized official

Name
Mrs. Eva Hernandez
Title
Owner
Phone
(305) 226-6357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X PH15959 FL Primary

Addresses

Primary practice location

10690 Fontainebleau Blvd
Miami, FL 33172-3117

Mailing address

10690 Fontainebleau Blvd
Miami, FL 33172-3117
Phone (305) 226-6357

Other identifiers 1

IdentifierTypeStateIssuer
106381200MedicaidFL

Other names 1

  • Nu-Mart Discount Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

10690 NW 7th St
Miami, FL 33172
Phone (305) 226-6357

Networks

  • HealthSun Health Plans Network

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222992000000",
    "number": "1124128939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10690 FONTAINEBLEAU BLVD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331723117",
            "telephone_number": "305-226-6357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10690 FONTAINEBLEAU BLVD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331723117",
            "telephone_number": "305-226-6357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FONTAINEBLEAU DISCOUNT PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2008-10-03",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "EVA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-226-6357",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PH15959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106381200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nu-Mart Discount Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 3, 2008; 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.