MEDICARE: DR. SANDRA DISCALA 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	246QM0706X	Medical Technologist	TN32400	FL
2	183500000X	Pharmacist	PS42623	FL

General Provider Information

NPI Number	:	1841400231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANDRA DISCALA PHARMD

Provider Business Mailing Address
First Line	:	7708 BOUGAINVILLEA CT
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33412-3118
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7305 NORTH MILITARY TRAIL
Second Line	:	VA MEDICAL CENTER
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33410
Country	:	US
Telephone Number	:	561-422-7214
Fax Number	:

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

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	08/10/2007

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