Healthcare Provider Details

I. General information

NPI: 1417743188
Provider Name (Legal Business Name): GIRGIS YOUNAN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: GIRGIS AYAD ABASHAROUN YOUNAN

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 BARTON BLVD UNIT C-14
ROCKLEDGE FL
32955-2742
US

IV. Provider business mailing address

PO BOX 1137
MELBOURNE FL
32902-1137
US

V. Phone/Fax

Practice location:
  • Phone: 321-241-6800
  • Fax: 321-241-6890
Mailing address:
  • Phone: 321-241-6800
  • Fax: 321-241-6890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS68538
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: