MEDICARE: DR. JAVIER DIAZ 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	PS40343	FL

General Provider Information

NPI Number	:	1932463239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAVIER DIAZ PHARMD

Provider Business Mailing Address
First Line	:	363 WASHINGTON AVE APT 33
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-6947
Country	:	US
Telephone Number	:	305-205-4003
Fax Number	:

Provider Business Practice Location Address
First Line	:	363 WASHINGTON AVE APT 33
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-6947
Country	:	US
Telephone Number	:	305-205-4003
Fax Number	:

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

Provider Enumeration Date	:	07/02/2012
Last Update Date	:	07/02/2012

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