Provider Demographics
NPI:1174625677
Name:BAKER HORN, RITA LA VERNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RITA
Middle Name:LA VERNE
Last Name:BAKER HORN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14580 NW 17TH DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33167-1000
Mailing Address - Country:US
Mailing Address - Phone:305-527-8377
Mailing Address - Fax:305-685-1301
Practice Address - Street 1:14900 NW 7TH AVE
Practice Address - Street 2:WINN-DIXIE PHARMACY #0343
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-3108
Practice Address - Country:US
Practice Address - Phone:305-685-1332
Practice Address - Fax:305-685-1301
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0020862183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0556050979Medicare ID - Type UnspecifiedMEDICARE# OF PHARMACY