OrganizationActive
Life Pharma Corp
NPI 1962123778 · Community/Retail Pharmacy · Miami, FL
Provider details
- NPI number
- 1962123778
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Jorge Hernandez Lara, President(305) 646-1111
Specialties & taxonomies
Suppliers
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1109 Nw 22nd Ave
Miami, FL 33125
Phone: (305) 646-1111
Fax: (786) 703-1242
Street-level locationGet directions
Mailing address
1109 Nw 22nd Ave
Miami, FL 33125
Registry dates
- Enumerated
- 2022-09-09
- Last updated
- 2022-12-09
- Certified
- 2022-12-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.