MEDICARE: DR. RITA LA VERNE BAKER HORN 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	PS0020862	FL

General Provider Information

NPI Number	:	1174625677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RITA LA VERNE BAKER HORN PHARM.D.

Provider Business Mailing Address
First Line	:	14580 NW 17TH DR
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33167-1000
Country	:	US
Telephone Number	:	305-527-8377
Fax Number	:	305-685-1301

Provider Business Practice Location Address
First Line	:	14900 NW 7TH AVE
Second Line	:	WINN-DIXIE PHARMACY #0343
City	:	MIAMI
State	:	FL
Zip	:	33168-3108
Country	:	US
Telephone Number	:	305-685-1332
Fax Number	:	305-685-1301

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

Provider Enumeration Date	:	09/04/2006
Last Update Date	:	07/09/2007

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