Provider Demographics
NPI:1114264272
Name:YATES, SEAN RYAN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:RYAN
Last Name:YATES
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-7240
Mailing Address - Country:US
Mailing Address - Phone:954-784-3872
Mailing Address - Fax:954-784-3897
Practice Address - Street 1:1405 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-7240
Practice Address - Country:US
Practice Address - Phone:954-784-3872
Practice Address - Fax:954-784-3897
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS39021183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist