MEDICARE: WINIFRED ADADZI III

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	PS46039	FL

General Provider Information

NPI Number	:	1316218357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WINIFRED ADADZI III

Provider Business Mailing Address
First Line	:	202 WALNUT CREST RUN
Second Line	:
City	:	SANFORD
State	:	FL
Zip	:	32771-7989
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 E STATE ROAD 434
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32750-5273
Country	:	US
Telephone Number	:	407-830-7350
Fax Number	:

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

Provider Enumeration Date	:	01/23/2012
Last Update Date	:	01/23/2012

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