Provider Demographics
NPI:1306855648
Name:YACHBES, BONNIE LORRAINE
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:LORRAINE
Last Name:YACHBES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 NW 100TH TER
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1057
Mailing Address - Country:US
Mailing Address - Phone:954-476-3664
Mailing Address - Fax:
Practice Address - Street 1:780 NW 100TH TER
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1057
Practice Address - Country:US
Practice Address - Phone:954-476-3664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS18629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist