MEDICARE: DR. SHELLEY ALEXANDER 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	PS37692	FL

General Provider Information

NPI Number	:	1194009365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHELLEY ALEXANDER PHARM.D.

Provider Business Mailing Address
First Line	:	6401 W COMMERCIAL BLVD
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33319-2110
Country	:	US
Telephone Number	:	954-571-2982
Fax Number	:	413-451-7656

Provider Business Practice Location Address
First Line	:	6401 W COMMERCIAL BLVD
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33319-2110
Country	:	US
Telephone Number	:	954-720-9243
Fax Number	:	954-720-4567

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

Provider Enumeration Date	:	10/05/2011
Last Update Date	:	10/12/2011

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