MEDICARE: MIAMI BEACH COMMUNITY HEALTH CENTER PHARMACY INC

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
2	3336C0003X	Community/Retail Pharmacy	PH25380	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2128801	OTHER	PK
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790081297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIAMI BEACH COMMUNITY HEALTH CENTER PHARMACY INC

Provider Business Mailing Address
First Line	:	11645 BISCAYNE BLVD STE 102
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-3138
Country	:	US
Telephone Number	:	305-538-8835
Fax Number	:	305-695-2168

Provider Business Practice Location Address
First Line	:	11645 BISCAYNE BLVD STE 102
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-3138
Country	:	US
Telephone Number	:	305-538-8835
Fax Number	:	305-695-2168

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MARK RABINOWITZ
Credential	:	MD
Telephone Number	:	305-538-8835

Provider Enumeration Date	:	01/31/2011
Last Update Date	:	12/23/2024

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