Provider Demographics
NPI:1437754033
Name:YATES, DANIEL RYAN (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:RYAN
Last Name:YATES
Suffix:
Gender:M
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7303 SW 17TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-5320
Mailing Address - Country:US
Mailing Address - Phone:609-221-5521
Mailing Address - Fax:
Practice Address - Street 1:2137 N YOUNG BLVD
Practice Address - Street 2:
Practice Address - City:CHIEFLAND
Practice Address - State:FL
Practice Address - Zip Code:32626-1955
Practice Address - Country:US
Practice Address - Phone:352-493-2592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS55859183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist