Provider Demographics
NPI:1427339258
Name:AMERICAN PHARMA DEPOT
Entity type:Organization
Organization Name:AMERICAN PHARMA DEPOT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GREGORIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-385-9919
Mailing Address - Street 1:13550 SW 88TH ST
Mailing Address - Street 2:SUITE 180
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1654
Mailing Address - Country:US
Mailing Address - Phone:305-385-9919
Mailing Address - Fax:305-386-9061
Practice Address - Street 1:13550 SW 88TH ST
Practice Address - Street 2:SUITE 180
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1654
Practice Address - Country:US
Practice Address - Phone:305-385-9919
Practice Address - Fax:305-386-9061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-07
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME56235261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service