Provider Demographics
NPI:1770865040
Name:YANG, CHRISTINA KER (RPH)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:KER
Last Name:YANG
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 1:15699 AVALON AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-2213
Mailing Address - Country:US
Mailing Address - Phone:727-642-9955
Mailing Address - Fax:727-398-6106
Practice Address - Street 1:10121 SEMINOLE BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-2543
Practice Address - Country:US
Practice Address - Phone:727-398-7308
Practice Address - Fax:727-398-6106
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43965183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist