MEDICARE: YANCY MITRANI

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	PS51015	FL

General Provider Information

NPI Number	:	1811322100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANCY MITRANI

Provider Business Mailing Address
First Line	:	6603 MARBLETREE LN
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-7238
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6603 MARBLETREE LN
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-7238
Country	:	US
Telephone Number	:	386-689-9682
Fax Number	:

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

Provider Enumeration Date	:	09/05/2013
Last Update Date	:	10/23/2017

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Directions to “ YANCY MITRANI ” Practice Location

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