| Entity Name: | MIAMI INFUSION & PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 14 Jun 2001 (24 years ago) |
| Document Number: | P01000059621 |
| FEI/EIN Number | 651115080 |
| Address: | 7160 WEST 20 AVE, SUITE M-129, HIALEAH, FL, 33016 |
| Mail Address: | 7160 WEST 20 AVE, SUITE M-129, HIALEAH, FL, 33016 |
| ZIP code: | 33016 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487768370 | 2006-08-18 | 2011-02-04 | 9280 SW 20TH ST, MIAMI, FL, 331657722, US | 7160 W 20TH AVE, STE M 129, HIALEAH, FL, 330165530, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-724-4599 |
Authorized person
| Name | MR. STEVE BRAUN |
| Role | PRES |
| Phone | 3057244599 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | PH18065 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 025339100 |
| State | FL |
| Issuer | OTHER ID NUMBER-COMMERCIAL NUMBER |
| Number | 1093537 |
| Issuer | MEDICAID |
| Number | 025339101 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LAMBERT PAUL WATSON | Agent | 1203 GOVERNORS SQUARE BLVD., TALLAHASSEE, FL, 323012560 |
| Name | Role | Address |
|---|---|---|
| BRAUN STEVE | President | 7160 WEST 20 AVE M-129, HIALEAH, FL, 33016 |
| Name | Role | Address |
|---|---|---|
| BRAUN STEVE | Director | 7160 WEST 20 AVE M-129, HIALEAH, FL, 33016 |
| FERRAN GEORGE | Director | 7160 WEST 20 AVE M-129, HIALEAH, FL, 33016 |
| Name | Role | Address |
|---|---|---|
| FERRAN GEORGE | Vice President | 7160 WEST 20 AVE M-129, HIALEAH, FL, 33016 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
