Provider Demographics
NPI:1962787606
Name:VERGARA, ARMANDO H (RPH)
Entity type:Individual
Prefix:MR
First Name:ARMANDO
Middle Name:H
Last Name:VERGARA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8498 NW 163RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6631
Mailing Address - Country:US
Mailing Address - Phone:305-825-2662
Mailing Address - Fax:
Practice Address - Street 1:8498 NW 163 TERR
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-6631
Practice Address - Country:US
Practice Address - Phone:305-825-2662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS28995183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist