MEDICARE: JUNG ON JU PHARM.D

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	PS 42232	FL

General Provider Information

NPI Number	:	1093916967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUNG ON JU PHARM.D

Provider Business Mailing Address
First Line	:	7904 NW 38TH CT
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-8311
Country	:	US
Telephone Number	:	954-701-6691
Fax Number	:

Provider Business Practice Location Address
First Line	:	820 NE 126TH ST
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-4906
Country	:	US
Telephone Number	:	305-887-9335
Fax Number	:	305-883-8869

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

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	07/08/2007

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