MEDICARE: MR. MICHAEL S YANCOSKIE 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	PS40730	FL

General Provider Information

NPI Number	:	1750629127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL S YANCOSKIE PHARMD

Provider Business Mailing Address
First Line	:	411 S CYPRESS RD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33060-7135
Country	:	US
Telephone Number	:	954-784-3284
Fax Number	:	954-784-3286

Provider Business Practice Location Address
First Line	:	411 S CYPRESS RD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33060-7135
Country	:	US
Telephone Number	:	954-784-3284
Fax Number	:	954-784-3286

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

Provider Enumeration Date	:	01/19/2013
Last Update Date	:	01/19/2013

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