MEDICARE: YELENA KRAYTER

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	PS39983	FL

General Provider Information

NPI Number	:	1538788161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YELENA KRAYTER

Provider Business Mailing Address
First Line	:	9 PINE CONE DR STE 109
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32137-8683
Country	:	US
Telephone Number	:	386-246-7898
Fax Number	:	386-246-7515

Provider Business Practice Location Address
First Line	:	9 PINE CONE DR STE 109
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32137-8683
Country	:	US
Telephone Number	:	386-246-7898
Fax Number	:	386-246-7515

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

Provider Enumeration Date	:	04/14/2020
Last Update Date	:	02/15/2022

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