MEDICARE: MS. SEREDA WHITE

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	PS22328	FL

General Provider Information

NPI Number	:	1942547724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SEREDA WHITE

Provider Business Mailing Address
First Line	:	450 NE 142ND ST
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-3131
Country	:	US
Telephone Number	:	305-951-1975
Fax Number	:	305-735-2331

Provider Business Practice Location Address
First Line	:	450 NE 142ND ST
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-3131
Country	:	US
Telephone Number	:	305-951-1975
Fax Number	:	305-735-2331

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

Provider Enumeration Date	:	01/13/2013
Last Update Date	:	01/13/2013

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Directions to “ MS. SEREDA WHITE ” Practice Location

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