Healthcare Provider Details

I. General information

NPI: 1356113765
Provider Name (Legal Business Name): KRISTEN MARIE YAUN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2023
Last Update Date: 10/27/2023
Certification Date: 10/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

839 N ORLANDO AVE
WINTER PARK FL
32789-2921
US

IV. Provider business mailing address

1874 HARMON AVE APT 422
WINTER PARK FL
32789-5468
US

V. Phone/Fax

Practice location:
  • Phone: 407-647-1862
  • Fax:
Mailing address:
  • Phone: 561-236-8042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS66493
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: