Provider Demographics
NPI:1538256722
Name:ARIGUANABO PHARMACY INC
Entity type:Organization
Organization Name:ARIGUANABO PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-264-3122
Mailing Address - Street 1:5755 W FLAGLER ST
Mailing Address - Street 2:STE 110
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-3441
Mailing Address - Country:US
Mailing Address - Phone:305-264-3122
Mailing Address - Fax:305-264-3151
Practice Address - Street 1:5755 W FLAGLER ST
Practice Address - Street 2:STE 110
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-3441
Practice Address - Country:US
Practice Address - Phone:305-264-3122
Practice Address - Fax:305-264-3151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH19003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2005255OtherPK
FL102136201Medicaid
FL1237560001Medicare NSC
FL102136200Medicaid
FL1237560001Medicare PIN