Provider Demographics
NPI:1588972780
Name:MORO, AIDA C (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AIDA
Middle Name:C
Last Name:MORO
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 1:3961 SW 126TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-2962
Mailing Address - Country:US
Mailing Address - Phone:305-644-3126
Mailing Address - Fax:305-643-2708
Practice Address - Street 1:3099 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4531
Practice Address - Country:US
Practice Address - Phone:305-644-3126
Practice Address - Fax:305-643-2708
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16749183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist