MEDICARE: MS. THERESA MARIE DROZD 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	30795	FL
2	183500000X	Pharmacist	6698	CT

General Provider Information

NPI Number	:	1952683690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. THERESA MARIE DROZD RPH

Provider Business Mailing Address
First Line	:	1805 N FLAGLER DR
Second Line	:	UNIT 110
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-6530
Country	:	US
Telephone Number	:	561-512-2658
Fax Number	:

Provider Business Practice Location Address
First Line	:	1805 N FLAGLER DR
Second Line	:	UNIT 110
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-6530
Country	:	US
Telephone Number	:	561-512-2658
Fax Number	:

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

Provider Enumeration Date	:	09/19/2011
Last Update Date	:	09/19/2011

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