MEDICARE: MITCHELL P MAGYAR PHARMD INTERN

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	390200000X	Student in an Organized Health Care Education/Training Program	PSI43184	FL

General Provider Information

NPI Number	:	1316879158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MITCHELL P MAGYAR PHARMD INTERN

Provider Business Mailing Address
First Line	:	14864 ENCLAVE LAKES DR APT C1
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-8816
Country	:	US
Telephone Number	:	954-881-4265
Fax Number	:

Provider Business Practice Location Address
First Line	:	16205 S MILITARY TRL
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-6503
Country	:	US
Telephone Number	:	561-495-8331
Fax Number	:	561-495-8312

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

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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