MEDICARE: DR. RICARD FERTIL 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
1	183500000X	Pharmacist	PS38108	FL

General Provider Information

NPI Number	:	1740356864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICARD FERTIL PHARMD

Provider Business Mailing Address
First Line	:	12720 NE MIAMI CT
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-4539
Country	:	US
Telephone Number	:	786-390-1833
Fax Number	:

Provider Business Practice Location Address
First Line	:	2170 NW 7TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-3425
Country	:	US
Telephone Number	:	305-631-8330
Fax Number	:

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

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	07/08/2007

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