Provider Demographics
NPI:1174647523
Name:YOUSEF, YASER SAMIH (RPH)
Entity Type:Individual
Prefix:MR
First Name:YASER
Middle Name:SAMIH
Last Name:YOUSEF
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 AVENUE K SE APT 213
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-4051
Mailing Address - Country:US
Mailing Address - Phone:863-294-0042
Mailing Address - Fax:863-421-0578
Practice Address - Street 1:36019 HWY 27
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-3740
Practice Address - Country:US
Practice Address - Phone:863-421-0639
Practice Address - Fax:863-421-0578
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 30225183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist