MEDICARE: MR. SAJI MATHEW JOHN RPH

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	42066	FL

General Provider Information

NPI Number	:	1811662448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SAJI MATHEW JOHN RPH

Provider Business Mailing Address
First Line	:	16184 MARIPOSA CIR N
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33331-4602
Country	:	US
Telephone Number	:	954-242-6675
Fax Number	:

Provider Business Practice Location Address
First Line	:	1255 W 46TH ST STE 5
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3257
Country	:	US
Telephone Number	:	786-359-4283
Fax Number	:	786-899-0980

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

Provider Enumeration Date	:	08/16/2021
Last Update Date	:	08/16/2021

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Directions to “ MR. SAJI MATHEW JOHN RPH” Practice Location

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