Provider Demographics
NPI:1902552177
Name:ROSALES, KIMBERLY ALEXIS (PHARMD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ALEXIS
Last Name:ROSALES
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 1:8001 MIRAMAR PKWY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3004
Mailing Address - Country:US
Mailing Address - Phone:954-437-9552
Mailing Address - Fax:
Practice Address - Street 1:8001 MIRAMAR PKWY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-3004
Practice Address - Country:US
Practice Address - Phone:954-437-9552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-26
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS63796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist