MEDICARE: MIKEEL YADIER CLASS MEDINA PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	8533	PR

General Provider Information

NPI Number	:	1043162969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIKEEL YADIER CLASS MEDINA PHARMD

Provider Business Mailing Address
First Line	:	HC 4 BOX 14303
Second Line	:
City	:	MOCA
State	:	PR
Zip	:	00676-9672
Country	:	US
Telephone Number	:	787-832-5620
Fax Number	:	787-265-0085

Provider Business Practice Location Address
First Line	:	62 CALLE DE DIEGO E
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00680-4803
Country	:	US
Telephone Number	:	787-832-5620
Fax Number	:	787-265-0085

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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