MEDICARE: YESENIA PRADOS

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	PS52085	FL

General Provider Information

NPI Number	:	1366850935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YESENIA PRADOS

Provider Business Mailing Address
First Line	:	15005 SW 88TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-1314
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15005 SW 88TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-1314
Country	:	US
Telephone Number	:	305-386-1244
Fax Number	:

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

Provider Enumeration Date	:	07/28/2014
Last Update Date	:	07/28/2014

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Directions to “ YESENIA PRADOS ” Practice Location

Language	Start Address	Practice Location

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