MEDICARE: MS. CARLETTA YOUNG EVANS RPH

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	PS14373	FL

General Provider Information

NPI Number	:	1235100975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CARLETTA YOUNG EVANS RPH

Provider Business Mailing Address
First Line	:	5550 SW 7TH PL
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33068-2917
Country	:	US
Telephone Number	:	954-969-9815
Fax Number	:

Provider Business Practice Location Address
First Line	:	5550 SW 7TH PL
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33068-2917
Country	:	US
Telephone Number	:	954-969-9815
Fax Number	:

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

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	12/09/2011

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