Mariya Gruen, PHARMD
Individual provider Active NPI Pharmacist · Surfside, FL
NPI 1821483074 · NPPES record last updated Apr 4, 2015
Key facts
- NPI
- 1821483074
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PS42484 (FL)
- Practice address
- 301 92ND St
Surfside, FL 33154-3007 - Phone
- (954) 256-6028
- NPI assigned
- Apr 4, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS42484 | FL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS42484 | FL | Yes |
Addresses
Primary practice location
301 92ND St
Surfside, FL 33154-3007
Mailing address
301 92ND St
Surfside, FL 33154-3007
Phone (954) 256-6028
Other providers in Surfside, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.