1492 PHARMA GROUP CORP NPI 1417968058

NPI Information

  • NPI: 1417968058
  • Provider Name: 1492 PHARMA GROUP CORP
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Doing Business As: MARCO DRUGS AND COMPOUNDING
  • CLIA Number: 10D2194666
  • Address: 6420 SW 62ND AVE
    SOUTH MIAMI, FL
    ZIP 33143
  • Phone: (305) 665-4411

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NPI Details

1492 PHARMA GROUP CORP is a pharmacy in South Miami, FL. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. 1492 PHARMA GROUP CORP NPI is 1417968058. The provider is registered as an organization entity type.
The provider Is Doing Business As Marco Drugs And Compounding.

The provider's business location address is:

6420 SW 62ND AVE
SOUTH MIAMI, FL
ZIP 33143-302
Phone: (305) 665-4411
Fax: (305) 663-3258

The provider's authorized official is Sonia Elena Martinez .
The authorized official title is President and has the following contact phone number (305) 665-4411.

The CLIA number assigned to this NPI record is 10D2194666 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Fee covid-19 vac 13 res (HCPCS:0124A)
  • Adm sarscov2 30mcg/0.3ml bst (HCPCS:0004A)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Adm sarscov2 100mcg/0.5ml3rd (HCPCS:0013A)

The enumeration date for this NPI number is 8/10/2006 and was last updated on 12/12/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail PharmacyPH22048FLORIDANo
23336C0004XPharmacyCompounding PharmacyNo
3333600000XPharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1007260700MEDICAIDFLORIDA
2019180600MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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