MEDICARE: MARIA CAROLINA ENRIQUEZ

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	26454	TN

General Provider Information

NPI Number	:	1417079898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA CAROLINA ENRIQUEZ

Provider Business Mailing Address
First Line	:	6200 ARLINGLTON APT UNIT 271 HIXSON PIKE
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343
Country	:	US
Telephone Number	:	423-255-9243
Fax Number	:	423-877-4175

Provider Business Practice Location Address
First Line	:	6200 ARLINGTON APT UNIT 271 HIXSON PIKE
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343
Country	:	US
Telephone Number	:	423-255-9243
Fax Number	:	423-877-4175

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

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	07/08/2007

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Directions to “ MARIA CAROLINA ENRIQUEZ ” Practice Location

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