MEDICARE: SEENA L HAINES PHARMD

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	1835P1200X	Pharmacotherapy Pharmacist	PS35147	FL

General Provider Information

NPI Number	:	1134122542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEENA L HAINES PHARMD

Provider Business Mailing Address
First Line	:	901 S FLAGLER DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-6505
Country	:	US
Telephone Number	:	561-803-2713
Fax Number	:	561-803-2703

Provider Business Practice Location Address
First Line	:	901 S FLAGLER DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-6505
Country	:	US
Telephone Number	:	561-803-2713
Fax Number	:	561-803-2703

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	10/21/2008

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