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NPI Code Detail

MEDICARE: DR. RAMA KRISHNA AL CLEMETSON PHARMD

MEDICARE: DR. RAMA KRISHNA AL CLEMETSON 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
1183500000XPharmacistPS41279FL

General Provider Information

NPI Number : 1164707360
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAMA KRISHNA AL CLEMETSON PHARMD
Provider Business Mailing Address
First Line : 440 NW 91ST ST
Second Line :
City : EL PORTAL
State : FL
Zip : 33150-2150
Country : US
Telephone Number : 305-418-0518
Fax Number :
Provider Business Practice Location Address
First Line : 12295 BISCAYNE BLVD
Second Line :
City : NORTH MIAMI
State : FL
Zip : 33181-2713
Country : US
Telephone Number : 305-893-6860
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2011
Last Update Date : 10/19/2011

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