MEDICARE: MS. PHYLLIS DEBORAH LUBER 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	14492	FL

General Provider Information

NPI Number	:	1881860377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PHYLLIS DEBORAH LUBER R.PH.

Provider Business Mailing Address
First Line	:	11736 HIGHLAND PL
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-7827
Country	:	US
Telephone Number	:	954-345-2325
Fax Number	:	954-757-3596

Provider Business Practice Location Address
First Line	:	9225 W SAMPLE RD
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-1627
Country	:	US
Telephone Number	:	954-752-2000
Fax Number	:	954-752-8832

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

Provider Enumeration Date	:	05/05/2008
Last Update Date	:	05/05/2008

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