MEDICARE: LFM PROFESSIONAL SERVICES 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

General Provider Information

NPI Number	:	1942338520
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LFM PROFESSIONAL SERVICES INC

Provider Business Mailing Address
First Line	:	10550 NW 77TH CT
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33016-7084
Country	:	US
Telephone Number	:	305-819-1942
Fax Number	:	305-819-1940

Provider Business Practice Location Address
First Line	:	10550 NW 77TH CT
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33016-7084
Country	:	US
Telephone Number	:	305-819-1942
Fax Number	:	305-819-1940

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HUMBERTO HERNANDEZ
Credential	:
Telephone Number	:	305-819-1942

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	08/12/2008

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