MEDICARE: MR. SCOTT CRAIG MAAS R.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	183500000X	Pharmacist	PS0015162	FL

General Provider Information

NPI Number	:	1770730590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT CRAIG MAAS R.PH

Provider Business Mailing Address
First Line	:	18768 NW 78TH PL
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-2769
Country	:	US
Telephone Number	:	305-829-7745
Fax Number	:	305-829-1253

Provider Business Practice Location Address
First Line	:	19167 S DIXIE HWY
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-7714
Country	:	US
Telephone Number	:	305-254-9088
Fax Number	:	305-254-9087

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

Provider Enumeration Date	:	08/22/2008
Last Update Date	:	08/22/2008

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