MEDICARE: MAIL ORDER MEDS OF FLORIDA, LLC

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	333600000X	Pharmacy	PH 18786	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1097129	OTHER		NCPDP PROVIDER ID

General Provider Information

NPI Number	:	1154370369
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAIL ORDER MEDS OF FLORIDA, LLC

Provider Business Mailing Address
First Line	:	4500 BISCAYNE BLVD
Second Line	:	SUITE 104
City	:	MIAMI
State	:	FL
Zip	:	33137-3227
Country	:	US
Telephone Number	:	888-368-6405
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 BISCAYNE BLVD
Second Line	:	SUITE 104
City	:	MIAMI
State	:	FL
Zip	:	33137-3227
Country	:	US
Telephone Number	:	888-368-6405
Fax Number	:

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	MR. GLENN G SCHABEL
Credential	:	R.PH.
Telephone Number	:	631-870-5129

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	03/07/2023

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