Provider Demographics
NPI:1750629127
Name:YANCOSKIE, MICHAEL S (PHARMD)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:S
Last Name:YANCOSKIE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 S CYPRESS RD
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-7135
Mailing Address - Country:US
Mailing Address - Phone:954-784-3284
Mailing Address - Fax:954-784-3286
Practice Address - Street 1:411 S CYPRESS RD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-7135
Practice Address - Country:US
Practice Address - Phone:954-784-3284
Practice Address - Fax:954-784-3286
Is Sole Proprietor?:No
Enumeration Date:2013-01-19
Last Update Date:2013-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40730183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist