Provider Demographics
NPI:1487045563
Name:LI, ANITA YIM YEE
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:YIM YEE
Last Name:LI
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 1:4869 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-1940
Mailing Address - Country:US
Mailing Address - Phone:941-209-3209
Mailing Address - Fax:
Practice Address - Street 1:2501 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-1251
Practice Address - Country:US
Practice Address - Phone:941-756-1867
Practice Address - Fax:941-739-1839
Is Sole Proprietor?:No
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS39389183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS39389OtherPHARMACIST LICENSE NUMBER