MEDICARE: DORIAN ORIGA

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	PS53929	FL

General Provider Information

NPI Number	:	1710356639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORIAN ORIGA

Provider Business Mailing Address
First Line	:	9510 SW 160TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33157-3300
Country	:	US
Telephone Number	:	305-971-9797
Fax Number	:	305-971-9720

Provider Business Practice Location Address
First Line	:	9510 SW 160TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33157-3300
Country	:	US
Telephone Number	:	305-971-9797
Fax Number	:	305-971-9720

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

Provider Enumeration Date	:	09/22/2015
Last Update Date	:	09/22/2015

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Directions to “ DORIAN ORIGA ” Practice Location

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