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NPI Code Detail

MEDICARE: IVETTE M MALDONADO RPH

MEDICARE:   IVETTE M MALDONADO  RPH
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
1183500000XPharmacistPS35061FL

General Provider Information

NPI Number : 1093098352
Entity Type Code : Individual
Provider Name (Legal Business Name) : IVETTE M MALDONADO RPH
Provider Business Mailing Address
First Line : 4530 LANTANA RD
Second Line :
City : LAKE WORTH
State : FL
Zip : 33463-6908
Country : US
Telephone Number : 561-963-2588
Fax Number :
Provider Business Practice Location Address
First Line : 4530 LANTANA RD
Second Line :
City : LAKE WORTH
State : FL
Zip : 33463-6908
Country : US
Telephone Number : 561-963-2588
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2011
Last Update Date : 09/23/2011

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Directions to “ IVETTE M MALDONADO RPH” Practice Location

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