Healthcare Provider Details

I. General information

NPI: 1689290462
Provider Name (Legal Business Name): YUNG HUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2020
Last Update Date: 06/17/2020
Certification Date: 06/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7644 PARK BLVD N
PINELLAS PARK FL
33781-3755
US

IV. Provider business mailing address

5411 BAYOU GRANDE BLVD NE
ST PETERSBURG FL
33703-1811
US

V. Phone/Fax

Practice location:
  • Phone: 727-685-0258
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS41526
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: