MEDICARE: LE SELECT PHARMACY & M.E.S., INC.

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	333600000X	Pharmacy	PH23982	FL

General Provider Information

NPI Number	:	1881829000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LE SELECT PHARMACY & M.E.S., INC.

Provider Business Mailing Address
First Line	:	PO BOX 351652
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-7652
Country	:	US
Telephone Number	:	305-642-5241
Fax Number	:

Provider Business Practice Location Address
First Line	:	128 NW 27TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-5114
Country	:	US
Telephone Number	:	305-642-5241
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MILAGROS PEREZ
Credential	:
Telephone Number	:	305-642-5241

Provider Enumeration Date	:	05/18/2009
Last Update Date	:	05/28/2009

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