Provider Demographics
NPI:1447395983
Name:MASCARY, PAUL CLAUDEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:CLAUDEL
Last Name:MASCARY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 NW 133RD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33168-2823
Mailing Address - Country:US
Mailing Address - Phone:305-333-1973
Mailing Address - Fax:
Practice Address - Street 1:1700 NE MIAMI GARDENS DR
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-5301
Practice Address - Country:US
Practice Address - Phone:305-945-7641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41734183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist