Provider Demographics
NPI:1023592755
Name:WANG, YUFENG (PHARMD)
Entity type:Individual
Prefix:
First Name:YUFENG
Middle Name:
Last Name:WANG
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 1:797 TEAGUE TRL APT 12304
Mailing Address - Street 2:
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-3176
Mailing Address - Country:US
Mailing Address - Phone:321-960-1020
Mailing Address - Fax:
Practice Address - Street 1:2005 N STATE ROAD 19
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-6782
Practice Address - Country:US
Practice Address - Phone:352-483-6183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS57874183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist