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NPI Code Detail

MEDICARE: JOSE A. TRAVIESO CPHT

MEDICARE: JOSE A. TRAVIESO CPHT
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
1183700000XPharmacy Technician1701-0086-0609-374FL

General Provider Information

NPI Number : 1053494567
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE A. TRAVIESO CPHT
Provider Business Mailing Address
First Line : 12327 NW 7TH LN
Second Line :
City : MIAMI
State : FL
Zip : 33182-2019
Country : US
Telephone Number : 305-297-8623
Fax Number :
Provider Business Practice Location Address
First Line : 2600 W FLAGLER ST
Second Line :
City : MIAMI
State : FL
Zip : 33135-1425
Country : US
Telephone Number : 305-644-7569
Fax Number : 305-644-3074
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 07/08/2007

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Directions to “ JOSE A. TRAVIESO CPHT” Practice Location

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