MEDICARE: L AND J PHARMACY DISCOUNT 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	3336C0003X	Community/Retail Pharmacy		FL

General Provider Information

NPI Number	:	1699183210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L AND J PHARMACY DISCOUNT INC

Provider Business Mailing Address
First Line	:	9620 SUNSET DR
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3250
Country	:	US
Telephone Number	:	305-551-0000
Fax Number	:	305-551-0001

Provider Business Practice Location Address
First Line	:	9620 SUNSET DR
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3250
Country	:	US
Telephone Number	:	305-551-0000
Fax Number	:	305-551-0001

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LILIAM SANTOS
Credential	:
Telephone Number	:	305-551-0000

Provider Enumeration Date	:	07/28/2014
Last Update Date	:	07/28/2014

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