MEDICARE: ALI DALILI R.PH., 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	PS0026173	FL

General Provider Information

NPI Number	:	1104924547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALI DALILI R.PH., PHARM. D.

Provider Business Mailing Address
First Line	:	254 MARLBERRY CIR
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33458-2848
Country	:	US
Telephone Number	:	561-691-3248
Fax Number	:

Provider Business Practice Location Address
First Line	:	1225 45TH ST
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2120
Country	:	US
Telephone Number	:	561-845-0559
Fax Number	:	561-845-8258

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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