Provider Demographics
NPI:1285903344
Name:NAIDU, YESH P (RPH)
Entity type:Individual
Prefix:MR
First Name:YESH
Middle Name:P
Last Name:NAIDU
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:YESHWANTH
Other - Middle Name:P
Other - Last Name:JAGANNIVAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:3851 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-6114
Mailing Address - Country:US
Mailing Address - Phone:727-822-6896
Mailing Address - Fax:727-894-0168
Practice Address - Street 1:3851 4TH ST N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-6114
Practice Address - Country:US
Practice Address - Phone:727-822-6896
Practice Address - Fax:727-894-0168
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS28823183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL18002397560Medicaid