MEDICARE: PHARMA ONE 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	333600000X	Pharmacy	PH25037	FL

General Provider Information

NPI Number	:	1588965180
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMA ONE INC.

Provider Business Mailing Address
First Line	:	4060 NW 37TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-4206
Country	:	US
Telephone Number	:	305-634-8444
Fax Number	:	305-634-5222

Provider Business Practice Location Address
First Line	:	4060 NW 37TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-4206
Country	:	US
Telephone Number	:	305-634-8444
Fax Number	:	305-634-5222

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSE R RODRIGUEZ
Credential	:
Telephone Number	:	305-634-8444

Provider Enumeration Date	:	11/12/2010
Last Update Date	:	04/13/2012

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Directions to “PHARMA ONE INC. ” Practice Location

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