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NPI Code Detail

MEDICARE: JORDAN ALEXANDER ROMAN PHARMD

MEDICARE: JORDAN ALEXANDER ROMAN PHARMD
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
1183500000XPharmacistPS57277FL

General Provider Information

NPI Number : 1720590029
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN ALEXANDER ROMAN PHARMD
Provider Business Mailing Address
First Line : 6800 W 28TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33018-5305
Country : US
Telephone Number : 305-828-0268
Fax Number :
Provider Business Practice Location Address
First Line : 6800 W 28TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33018-5305
Country : US
Telephone Number : 305-828-0268
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2017
Last Update Date : 10/26/2017

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