MEDICARE: UP AND DOWN LLC

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	3336C0002X	Clinic Pharmacy	ME21440	FL

General Provider Information

NPI Number	:	1013493253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UP AND DOWN LLC

Provider Business Mailing Address
First Line	:	9425 BLIND PASS RD # 1305
Second Line	:
City	:	ST PETE BEACH
State	:	FL
Zip	:	33706-1351
Country	:	US
Telephone Number	:	727-367-3933
Fax Number	:

Provider Business Practice Location Address
First Line	:	722 W DR MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603-3133
Country	:	US
Telephone Number	:	813-221-8122
Fax Number	:	813-221-8031

Authorized Official
Title or Position	:	MANGER
Name	:	JANICE ARTHUR
Credential	:
Telephone Number	:	727-367-3933

Provider Enumeration Date	:	07/11/2018
Last Update Date	:	07/11/2018

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Directions to “UP AND DOWN LLC ” Practice Location

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