MEDICARE: DR. LEKESHIA J. BUSH 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	183500000X	Pharmacist	PS0034837	FL

General Provider Information

NPI Number	:	1649253915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEKESHIA J. BUSH PHARM.D.

Provider Business Mailing Address
First Line	:	5361 NW 22ND AVE STE 2
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-8035
Country	:	US
Telephone Number	:	786-437-1441
Fax Number	:	786-437-1442

Provider Business Practice Location Address
First Line	:	16800 NW 2ND AVE STE 100
Second Line	:	WALGREENS SUITE 100
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33169-5504
Country	:	US
Telephone Number	:	305-770-2540
Fax Number	:	305-770-2548

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

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	06/13/2019

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