MEDICARE: BERNARD CIMINO JR. 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	PS13941	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PS13941	OTHER	FL	STATE LICENSE #

General Provider Information

NPI Number	:	1962817734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERNARD CIMINO JR. RPH

Provider Business Mailing Address
First Line	:	2525 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-2408
Country	:	US
Telephone Number	:	813-870-1476
Fax Number	:	813-871-2031

Provider Business Practice Location Address
First Line	:	2525 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-2408
Country	:	US
Telephone Number	:	813-870-1476
Fax Number	:	813-871-2031

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

Provider Enumeration Date	:	06/30/2014
Last Update Date	:	06/30/2014

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Directions to “ BERNARD CIMINO JR. RPH” Practice Location

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