=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326247099
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEPHEN BARRY YOBLONSKY R.PH.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2007
-----------------------------------------------------
Last Update Date | 07/13/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16203 SOUTH MILITARY DRIVE
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33484
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-495-8312
-----------------------------------------------------
Fax | 561-495-8312
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16203 SOUTH MILITARY DRIVE
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33484
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-495-8312
-----------------------------------------------------
Fax | 561-495-8312
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PS0032913
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------