MEDICARE: ABIGAIL PO ANG 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	183500000X	Pharmacist	PS61588	FL

General Provider Information

NPI Number	:	1982219325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL PO ANG PHARMD

Provider Business Mailing Address
First Line	:	9359 SHERIDAN ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-8560
Country	:	US
Telephone Number	:	954-433-2710
Fax Number	:

Provider Business Practice Location Address
First Line	:	9359 SHERIDAN ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-8560
Country	:	US
Telephone Number	:	954-433-2710
Fax Number	:

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

Provider Enumeration Date	:	09/12/2020
Last Update Date	:	09/12/2020

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