MEDICARE: DR. SOFONIE LUINORD PHARMD

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	56947	FL

General Provider Information

NPI Number	:	1093232373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SOFONIE LUINORD PHARMD

Provider Business Mailing Address
First Line	:	101 N CONGRESS AVE
Second Line	:
City	:	LAKE PARK
State	:	FL
Zip	:	33403-3804
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 N CONGRESS AVE
Second Line	:
City	:	LAKE PARK
State	:	FL
Zip	:	33403-3804
Country	:	US
Telephone Number	:	561-842-8966
Fax Number	:

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

Provider Enumeration Date	:	08/28/2017
Last Update Date	:	03/17/2018

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