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NPI Code Detail

MEDICARE: YUREA PARK

MEDICARE: YUREA PARK
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
1183500000XPharmacistPS56334FL

General Provider Information

NPI Number : 1700396926
Entity Type Code : Individual
Provider Name (Legal Business Name) : YUREA PARK
Provider Business Mailing Address
First Line : 6324 ORANGE COVE DR
Second Line :
City : ORLANDO
State : FL
Zip : 32819-4171
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3900 WOODLAND AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4551
Country : US
Telephone Number : 215-823-5228
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2017
Last Update Date : 10/02/2017

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Directions to “ YUREA PARK ” Practice Location

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