MEDICARE: FARMACIA LAS AMERICAS, LLC

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	333600000X	Pharmacy	000000000000000	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700114030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FARMACIA LAS AMERICAS, LLC

Provider Business Mailing Address
First Line	:	1800 FOREST HILL BLVD STE B12
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6070
Country	:	US
Telephone Number	:	561-642-7590
Fax Number	:	561-642-7593

Provider Business Practice Location Address
First Line	:	1800 FOREST HILL BLVD STE B12
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6070
Country	:	US
Telephone Number	:	561-642-7590
Fax Number	:	561-642-7593

Authorized Official
Title or Position	:	PHARMACY OWNER
Name	:	DR. ANA B JIMENEZ
Credential	:	PHARM D
Telephone Number	:	561-642-7590

Provider Enumeration Date	:	11/24/2009
Last Update Date	:	11/24/2009

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Directions to “FARMACIA LAS AMERICAS, LLC ” Practice Location

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