MEDICARE: BORIS LOPATA PHARM.D.

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	PS44027	FL

General Provider Information

NPI Number	:	1659618429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BORIS LOPATA PHARM.D.

Provider Business Mailing Address
First Line	:	12850 BISCAYNE BLVD
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-2007
Country	:	US
Telephone Number	:	305-892-7094
Fax Number	:	305-892-7097

Provider Business Practice Location Address
First Line	:	12850 BISCAYNE BLVD
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-2007
Country	:	US
Telephone Number	:	305-892-7094
Fax Number	:	305-892-7097

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

Provider Enumeration Date	:	01/13/2013
Last Update Date	:	01/13/2013

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