MEDICARE: MARYSE JEAN-LOUIS PIERRE PHARM D

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	PS23684	FL

General Provider Information

NPI Number	:	1235479486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYSE JEAN-LOUIS PIERRE PHARM D

Provider Business Mailing Address
First Line	:	15443 SW 35TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-4745
Country	:	US
Telephone Number	:	786-564-0979
Fax Number	:

Provider Business Practice Location Address
First Line	:	15443 SW 35TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-4745
Country	:	US
Telephone Number	:	786-564-0979
Fax Number	:

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

Provider Enumeration Date	:	02/26/2013
Last Update Date	:	02/26/2013

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