MEDICARE: DELA AMI VARGAS 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	PU8360	FL

General Provider Information

NPI Number	:	1609333236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DELA AMI VARGAS PHARMD

Provider Business Mailing Address
First Line	:	6260 WILES RD APT 202
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-4311
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6260 WILES RD APT 202
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-4311
Country	:	US
Telephone Number	:	754-222-3639
Fax Number	:

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

Provider Enumeration Date	:	03/01/2019
Last Update Date	:	05/06/2019

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