MEDICARE: MR. JEFFREY S LEE RPH

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	PS022883	FL

General Provider Information

NPI Number	:	1801134481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFREY S LEE RPH

Provider Business Mailing Address
First Line	:	1101 8TH AVE W
Second Line	:
City	:	PALMETTO
State	:	FL
Zip	:	34221-3809
Country	:	US
Telephone Number	:	941-721-8681
Fax Number	:	941-721-8796

Provider Business Practice Location Address
First Line	:	1101 8TH AVE W
Second Line	:
City	:	PALMETTO
State	:	FL
Zip	:	34221-3809
Country	:	US
Telephone Number	:	941-721-8681
Fax Number	:	941-721-8796

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

Provider Enumeration Date	:	01/16/2013
Last Update Date	:	01/16/2013

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