Provider Demographics
NPI:1861973869
Name:ALZAMORA, ROSA MAYTEE
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:MAYTEE
Last Name:ALZAMORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 NW 85TH TER APT 2006
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1243
Mailing Address - Country:US
Mailing Address - Phone:305-587-0342
Mailing Address - Fax:
Practice Address - Street 1:1776 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-1129
Practice Address - Country:US
Practice Address - Phone:305-358-3433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS58308183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist