=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437748118
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LISBELL CARRERAS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/15/2021
-----------------------------------------------------
Last Update Date | 01/15/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18500 COLLINS AVE
-----------------------------------------------------
City | SUNNY ISLES BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33160-2427
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-792-4099
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1120 102ND ST APT 2
-----------------------------------------------------
City | BAY HARBOR ISLANDS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33154-1245
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-402-2491
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183700000X
-----------------------------------------------------
Taxonomy Name | Pharmacy Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------