Provider Demographics
NPI:1093492340
Name:AMMARI, YAZAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:YAZAN
Middle Name:
Last Name:AMMARI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6680 BENNETT CREEK DR APT 1022
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-0049
Mailing Address - Country:US
Mailing Address - Phone:904-469-5100
Mailing Address - Fax:
Practice Address - Street 1:6680 BENNETT CREEK DR APT 1022
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-0049
Practice Address - Country:US
Practice Address - Phone:904-469-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS58955183500000X
GARPH033511183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist