Provider Demographics
NPI:1386981140
Name:POTOSME, DALIA MARIA (PHARMD)
Entity type:Individual
Prefix:
First Name:DALIA
Middle Name:MARIA
Last Name:POTOSME
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 NW 1ST ST APT 6
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33128-1532
Mailing Address - Country:US
Mailing Address - Phone:786-385-3761
Mailing Address - Fax:
Practice Address - Street 1:7800 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-2536
Practice Address - Country:US
Practice Address - Phone:954-883-8418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47727183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist