Ultima RX LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH0019526 Issued in FL

Legal business name

ULTIMA RX LLC

Practice address

3900 NW 79TH Avenue
Suite 216
Doral, FL 33166

Phone

(305) 557-9512

Fax

(305) 552-9291

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Leo Cuervo, RPH

Title

President

Phone

(305) 557-9512

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ultima Rx Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Art Diaz Jr., BS PHARMACY

  • Pharmacist
  • Doral, FL
  • NPI 1780729871
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349222400000",
    "number": "1295827301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 NW 79TH AVENUE",
            "address_2": "SUITE 216",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "33166",
            "telephone_number": "305-557-9512",
            "fax_number": "305-552-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 NW 79TH AVENUE",
            "address_2": "SUITE 216",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "33166",
            "telephone_number": "305-557-9512",
            "fax_number": "305-552-9291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMA RX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2012-10-03",
        "status": "A",
        "authorized_official_last_name": "CUERVO",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-557-9512",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH0019526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004621900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ultima Rx",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Doral, FL
• Providers in Doral, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.