MEDICARE: ANGELITO FARMACIA DISCOUNT, INC.

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	3336C0003X	Community/Retail Pharmacy	PH 16351	FL

General Provider Information

NPI Number	:	1447283726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELITO FARMACIA DISCOUNT, INC.

Provider Business Mailing Address
First Line	:	3890 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33013-2704
Country	:	US
Telephone Number	:	305-820-4010
Fax Number	:	305-820-4004

Provider Business Practice Location Address
First Line	:	3890 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33013-2704
Country	:	US
Telephone Number	:	305-820-4010
Fax Number	:	305-820-4004

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CLAUDIO P. NAVARRO
Credential	:
Telephone Number	:	305-820-4010

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	03/19/2008

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