MEDICARE: LUMA I ARYAN R.PH

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	PS33143	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PS33143	OTHER	FL	FL MEDICAL LICENSE

General Provider Information

NPI Number	:	1871633750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUMA I ARYAN R.PH

Provider Business Mailing Address
First Line	:	15482 SW 115TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-6310
Country	:	US
Telephone Number	:	305-374-5120
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 NW 1ST ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33128-1902
Country	:	US
Telephone Number	:	305-374-5120
Fax Number	:

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

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	07/08/2007

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Directions to “ LUMA I ARYAN R.PH” Practice Location

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