MEDICARE: DR. BRANDON HAARER BS, 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	PS56494	FL

General Provider Information

NPI Number	:	1003332123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRANDON HAARER BS, PHARMD

Provider Business Mailing Address
First Line	:	1406 RAVINIA CIR
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34292-1598
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1251 S TOLEDO BLADE BLVD
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34288-2410
Country	:	US
Telephone Number	:	941-240-5023
Fax Number	:

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

Provider Enumeration Date	:	08/21/2017
Last Update Date	:	08/21/2017

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