Provider Demographics
NPI:1356868251
Name:JO-HEIRY, YOOMEE
Entity Type:Individual
Prefix:
First Name:YOOMEE
Middle Name:
Last Name:JO-HEIRY
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 1:239 QUEEN VICTORIA AVE
Mailing Address - Street 2:
Mailing Address - City:ST JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-5902
Mailing Address - Country:US
Mailing Address - Phone:904-625-5454
Mailing Address - Fax:
Practice Address - Street 1:1190 DUNN AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-4832
Practice Address - Country:US
Practice Address - Phone:904-751-4346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-23
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty