MEDICARE: FLOYD A. CARLOCK R.PH.

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	PS31206	FL
2	183500000X	Pharmacist	PU6816	FL

General Provider Information

NPI Number	:	1457633265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FLOYD A. CARLOCK R.PH.

Provider Business Mailing Address
First Line	:	7605 W 33RD CT
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-5003
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7605 W 33RD CT
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-5003
Country	:	US
Telephone Number	:	305-557-6395
Fax Number	:

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

Provider Enumeration Date	:	09/16/2011
Last Update Date	:	09/16/2011

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