MEDICARE: MRS. MAIRA GARCIA RPH

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	PS0027609	FL

General Provider Information

NPI Number	:	1861776247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MAIRA GARCIA RPH

Provider Business Mailing Address
First Line	:	16221 ABERDEEN WAY
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33014-6567
Country	:	US
Telephone Number	:	305-322-2082
Fax Number	:

Provider Business Practice Location Address
First Line	:	4451 W 12TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4100
Country	:	US
Telephone Number	:	305-556-8676
Fax Number	:

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

Provider Enumeration Date	:	10/04/2011
Last Update Date	:	10/04/2011

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