MEDICARE: EDITH BUESA

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	PS30038	FL

General Provider Information

NPI Number	:	1689885923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDITH BUESA

Provider Business Mailing Address
First Line	:	19380 SW 24TH ST
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33029-5926
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3960 W 12TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4105
Country	:	US
Telephone Number	:	305-556-3117
Fax Number	:

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

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	07/08/2007

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Directions to “ EDITH BUESA ” Practice Location

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