MEDICARE: MS. JEN-LING LEE

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	PS38696	FL

General Provider Information

NPI Number	:	1710055546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JEN-LING LEE

Provider Business Mailing Address
First Line	:	11862 SW 81ST RD
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33156-4420
Country	:	US
Telephone Number	:	305-232-8366
Fax Number	:

Provider Business Practice Location Address
First Line	:	45 CURTISS PKWY
Second Line	:
City	:	MIAMI SPRINGS
State	:	FL
Zip	:	33166-5218
Country	:	US
Telephone Number	:	305-888-5259
Fax Number	:

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

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	07/08/2007

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