Provider Demographics
NPI:1609291129
Name:SANTOS-VAZQUEZ, YENEISI (RPH)
Entity Type:Individual
Prefix:
First Name:YENEISI
Middle Name:
Last Name:SANTOS-VAZQUEZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 NORTH PINE ISLAND ROAD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322
Mailing Address - Country:US
Mailing Address - Phone:954-472-3305
Mailing Address - Fax:954-472-3390
Practice Address - Street 1:1885 NORTH PINE ISLAND ROAD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322
Practice Address - Country:US
Practice Address - Phone:954-472-3305
Practice Address - Fax:954-472-3390
Is Sole Proprietor?:No
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS51259183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist