MEDICARE: JUSTIN GOREE 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	PS51062	FL

General Provider Information

NPI Number	:	1740618941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN GOREE PHARMD

Provider Business Mailing Address
First Line	:	1545 ROCK SPRINGS RD
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32712-2231
Country	:	US
Telephone Number	:	407-880-7755
Fax Number	:

Provider Business Practice Location Address
First Line	:	1545 ROCK SPRINGS RD
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32712-2231
Country	:	US
Telephone Number	:	407-880-7755
Fax Number	:

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

Provider Enumeration Date	:	10/24/2013
Last Update Date	:	10/24/2013

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