MEDICARE: KAREN BRISITA 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	183500000X	Pharmacist	PS35948	FL

General Provider Information

NPI Number	:	1891071833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN BRISITA PHARMD

Provider Business Mailing Address
First Line	:	8421 SW 124TH AVE
Second Line	:	#101
City	:	MIAMI
State	:	FL
Zip	:	33183-4624
Country	:	US
Telephone Number	:	305-479-7308
Fax Number	:

Provider Business Practice Location Address
First Line	:	12630 SW 120TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186
Country	:	US
Telephone Number	:	305-253-7837
Fax Number	:

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

Provider Enumeration Date	:	10/21/2011
Last Update Date	:	10/21/2011

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