MEDICARE: YAMNELYS FERNANDEZ 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	PS39189	FL

General Provider Information

NPI Number	:	1619077336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAMNELYS FERNANDEZ RPH

Provider Business Mailing Address
First Line	:	3065 COLLIN DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-5012
Country	:	US
Telephone Number	:	561-968-8690
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 BELVEDERE RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-1229
Country	:	US
Telephone Number	:	561-659-7662
Fax Number	:	561-659-4364

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

Provider Enumeration Date	:	09/23/2006
Last Update Date	:	07/08/2007

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