MEDICARE: MR. RAMZI YACOUB 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	PS36681	FL

General Provider Information

NPI Number	:	1063623049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RAMZI YACOUB PHARM.D.

Provider Business Mailing Address
First Line	:	6301 NW 5TH WAY
Second Line	:	SUITE 5010
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-6131
Country	:	US
Telephone Number	:	800-851-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	6301 NW 5TH WAY
Second Line	:	SUITE 5010
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-6131
Country	:	US
Telephone Number	:	800-851-1000
Fax Number	:

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

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	07/08/2007

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