MEDICARE: DR. JERILYN B PETROPOULOS BS, PHARMD, BCPS

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	PS32254	FL
2	1835P1200X	Pharmacotherapy Pharmacist	PS32254	FL

General Provider Information

NPI Number	:	1689669889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERILYN B PETROPOULOS BS, PHARMD, BCPS

Provider Business Mailing Address
First Line	:	200 SE 5TH AVE
Second Line	:	UNIT 508
City	:	DANIA BEACH
State	:	FL
Zip	:	33004-4073
Country	:	US
Telephone Number	:	954-927-4280
Fax Number	:	305-575-3394

Provider Business Practice Location Address
First Line	:	1201 NW 16TH ST
Second Line	:	(119)
City	:	MIAMI
State	:	FL
Zip	:	33125-1624
Country	:	US
Telephone Number	:	888-276-1785
Fax Number	:

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	09/11/2025

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