MEDICARE: MARIA DE LA CARIDAD LUIS

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	183700000X	Pharmacy Technician	RPT38	FL

General Provider Information

NPI Number	:	1730488487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA DE LA CARIDAD LUIS

Provider Business Mailing Address
First Line	:	2527 W 65TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-6316
Country	:	US
Telephone Number	:	305-490-3111
Fax Number	:

Provider Business Practice Location Address
First Line	:	2017 W 62ND ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-2678
Country	:	US
Telephone Number	:	305-512-0941
Fax Number	:

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

Provider Enumeration Date	:	03/21/2011
Last Update Date	:	03/21/2011

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Directions to “ MARIA DE LA CARIDAD LUIS ” Practice Location

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