MEDICARE: MUNEVERA KAPIDZIC RPH

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	PS47412	FL

General Provider Information

NPI Number	:	1427695501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUNEVERA KAPIDZIC RPH

Provider Business Mailing Address
First Line	:	5647 ROOSEVELT BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-2301
Country	:	US
Telephone Number	:	904-384-4640
Fax Number	:	904-384-3922

Provider Business Practice Location Address
First Line	:	5647 ROOSEVELT BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-2301
Country	:	US
Telephone Number	:	904-384-4640
Fax Number	:	904-384-3922

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

Provider Enumeration Date	:	12/08/2019
Last Update Date	:	12/08/2019

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