MEDICARE: MR. FRANKLIN MATOS R.PH., C.PH.

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	1835P1200X	Pharmacotherapy Pharmacist	PS21779	FL
2	1835P1200X	Pharmacotherapy Pharmacist	PU5692	FL

General Provider Information

NPI Number	:	1447257613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FRANKLIN MATOS R.PH., C.PH.

Provider Business Mailing Address
First Line	:	1500 HOVERSHAM DR
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-4252
Country	:	US
Telephone Number	:	727-375-0236
Fax Number	:

Provider Business Practice Location Address
First Line	:	5535 MEMORIAL HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-7370
Country	:	US
Telephone Number	:	813-889-9779
Fax Number	:	813-889-9724

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

Provider Enumeration Date	:	07/03/2005
Last Update Date	:	07/08/2007

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