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General NPI Number Information
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NPI Number | 1467978007
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Entity Type | Individual
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Provider Name | SHAWN THOMAS KLYACHMAN PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 08/15/2017
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Last Update Date | 08/15/2017
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Provider Practice Location Address
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Address Line | 1776 BISCAYNE BLVD
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City | MIAMI
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State | FL
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Zip | 33132-1129
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Country | US
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Telephone | 305-358-3433
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Fax |
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Provider Business Mailing Address
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Address Line | 16900 N BAY RD APT 807
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City | SUNNY ISLES BEACH
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State | FL
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Zip | 33160-4266
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Country | US
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Telephone | 917-463-6433
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS56640
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License Number State | FL
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