MEDICARE: DR. FRANK LA CORTE C.PH., P.D.

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	183500000X	Pharmacist	PS31683	FL
2	183500000X	Pharmacist	PU6651	FL

General Provider Information

NPI Number	:	1053732529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK LA CORTE C.PH., P.D.

Provider Business Mailing Address
First Line	:	8349 NW 51ST MNR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-2807
Country	:	US
Telephone Number	:	954-803-3829
Fax Number	:

Provider Business Practice Location Address
First Line	:	8349 NW 51ST MNR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-2807
Country	:	US
Telephone Number	:	954-803-3829
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2013
Last Update Date	:	12/30/2013

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