Provider Demographics
NPI:1497004246
Name:FERNANDEZ, YOADYS (PHARMD)
Entity Type:Individual
Prefix:
First Name:YOADYS
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8505 SW 152ND AVE APT 274
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-4100
Mailing Address - Country:US
Mailing Address - Phone:786-470-0958
Mailing Address - Fax:
Practice Address - Street 1:8327 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2029
Practice Address - Country:US
Practice Address - Phone:305-261-2214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49282183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS49282OtherPHARMACY LICENSE