Mar-Lac Pharmacy Discount & Supply Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH23601 Issued in FL

Legal business name

MAR-LAC PHARMACY DISCOUNT & SUPPLY CORP

Doing business as

Mar-Lac Pharmacy Discount & Supply

Practice address

1109 NW 22ND Ave
Miami, FL 33125-2738

Phone

(305) 631-6602

Fax

(305) 631-6603

NPI assigned

Sep 30, 2008

Last updated

Aug 15, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ernesto Diaz

Title

President

Phone

(305) 631-6602

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Mar-Lac Pharmacy Discount & Supply Doing business as

Locations

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502755200000",
    "number": "1417108184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 NW 22ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331252738",
            "telephone_number": "305-631-6602",
            "fax_number": "305-631-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 NW 22ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331252738",
            "telephone_number": "305-631-6602",
            "fax_number": "305-631-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAR-LAC PHARMACY DISCOUNT & SUPPLY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-30",
        "last_updated": "2017-08-15",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "ERNESTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-631-6602"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH23601",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2126986",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mar-Lac Pharmacy Discount & Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kyrenia Maqueira, PTA
• Yamel Maqueira, DDS
• Elena Victoria Maquilon Osorio
• Mar Medical Center LLC
• Mar-Lac Pharmacy Discount & Supply
• Francesca Linette Maradiaga, SLP
• Samara Miranda Maradiaga
• Camila Marana, ARNP
• Maranatha Pharmacy Corp
• Margarita Marante Reyes

• Community/Retail Pharmacy in Miami, FL
• Providers in Miami, 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 Aug 15, 2017; 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.