Provider Demographics
NPI:1679842975
Name:YADAV, PAYALBEN
Entity Type:Individual
Prefix:DR
First Name:PAYALBEN
Middle Name:
Last Name:YADAV
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 1:2353 OCOEE APOPKA RD
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-5301
Mailing Address - Country:US
Mailing Address - Phone:407-573-0228
Mailing Address - Fax:
Practice Address - Street 1:2353 OCOEE APOPKA RD
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-5301
Practice Address - Country:US
Practice Address - Phone:407-573-0228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS46445183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist