MEDICARE: PHARMACY PRACTICE ASSOCIATES, PA

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	1835P1200X	Pharmacotherapy Pharmacist	PU6074	FL

General Provider Information

NPI Number	:	1497878326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMACY PRACTICE ASSOCIATES, PA

Provider Business Mailing Address
First Line	:	4095 STATE ROAD 7
Second Line	:	SUITE L-208
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-8178
Country	:	US
Telephone Number	:	954-610-0727
Fax Number	:

Provider Business Practice Location Address
First Line	:	4095 STATE ROAD 7
Second Line	:	SUITE L-208
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-8178
Country	:	US
Telephone Number	:	954-610-0727
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DION HAYDEN HERRERA
Credential	:	PHARMD
Telephone Number	:	954-610-0727

Provider Enumeration Date	:	04/07/2007
Last Update Date	:	08/22/2020

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