MEDICARE: DR. LISA A ADAMICH 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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	PS-22330	FL

General Provider Information

NPI Number	:	1881987709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA A ADAMICH PHARMD

Provider Business Mailing Address
First Line	:	3089 EAGLES LANDING CIR W
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33761-2818
Country	:	US
Telephone Number	:	727-639-5583
Fax Number	:

Provider Business Practice Location Address
First Line	:	4035 TAMPA RD
Second Line	:	SUITE 6500
City	:	OLDSMAR
State	:	FL
Zip	:	34677-3227
Country	:	US
Telephone Number	:	813-854-1448
Fax Number	:

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

Provider Enumeration Date	:	05/25/2011
Last Update Date	:	05/25/2011

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