Provider Demographics
NPI:1477146017
Name:ADESHINA, YINKA (RPH)
Entity type:Individual
Prefix:
First Name:YINKA
Middle Name:
Last Name:ADESHINA
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 1:1621 CROSSPOINTE WAY
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4767
Mailing Address - Country:US
Mailing Address - Phone:850-300-0494
Mailing Address - Fax:
Practice Address - Street 1:1621 CROSSPOINTE WAY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4767
Practice Address - Country:US
Practice Address - Phone:850-300-0494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35156183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist