Provider Demographics
NPI:1467978007
Name:KLYACHMAN, SHAWN THOMAS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:THOMAS
Last Name:KLYACHMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16900 N BAY RD APT 807
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4266
Mailing Address - Country:US
Mailing Address - Phone:917-463-6433
Mailing Address - Fax:
Practice Address - Street 1:1776 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-1129
Practice Address - Country:US
Practice Address - Phone:305-358-3433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS56640183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist