MEDICARE: PHARMALIFE #2, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	PH25410	FL

General Provider Information

NPI Number	:	1013209295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMALIFE #2, INC.

Provider Business Mailing Address
First Line	:	4443 NW 2ND AVENUE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33127
Country	:	US
Telephone Number	:	305-572-9210
Fax Number	:	305-572-9260

Provider Business Practice Location Address
First Line	:	4443 NW 2 AVENUE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33127
Country	:	US
Telephone Number	:	305-572-9210
Fax Number	:	305-572-9260

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ALBERTO DORADO
Credential	:
Telephone Number	:	305-668-6684

Provider Enumeration Date	:	05/06/2011
Last Update Date	:	05/06/2011

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Directions to “PHARMALIFE #2, INC. ” Practice Location

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