MEDICARE: DR. BRANDON J SMITH PHARMD

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	PS50396	FL

General Provider Information

NPI Number	:	1346680303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRANDON J SMITH PHARMD

Provider Business Mailing Address
First Line	:	718 MAGUIRE BLVD
Second Line	:	TARGET PHARMACY STORE NUMBER T-0649
City	:	ORLANDO
State	:	FL
Zip	:	32803-3706
Country	:	US
Telephone Number	:	407-895-1025
Fax Number	:	407-541-3400

Provider Business Practice Location Address
First Line	:	718 MAGUIRE BLVD
Second Line	:	TARGET PHARMACY STORE NUMBER T-0649
City	:	ORLANDO
State	:	FL
Zip	:	32803-3706
Country	:	US
Telephone Number	:	407-895-1025
Fax Number	:	407-541-3400

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

Provider Enumeration Date	:	07/04/2013
Last Update Date	:	07/04/2013

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