Provider Demographics
NPI:1619244407
Name:YOUSAF, ANIL (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ANIL
Middle Name:
Last Name:YOUSAF
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15622 NW 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1564
Mailing Address - Country:US
Mailing Address - Phone:954-732-8528
Mailing Address - Fax:
Practice Address - Street 1:5101 NW 21ST AVE STE 520-530
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-2792
Practice Address - Country:US
Practice Address - Phone:954-739-4115
Practice Address - Fax:954-484-5431
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist