Individual provider Active NPI

So Man Amanda Au-Yeung

  • Pharmacist
  • Winter Haven, FL
National Provider Identifier
1053958132
Registry record updated Dec 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS60050 Issued in FL
Practice address
705 1St St S
Winter Haven, FL 33880-3602
Phone
(863) 294-7487
NPI assigned
Dec 8, 2019
Last updated
Dec 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS60050 FL Primary

Addresses

Primary practice location

705 1St St S
Winter Haven, FL 33880-3602

Mailing address

705 1St St S
Winter Haven, FL 33880-3602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PS60050FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Dec 15, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1575763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575763200000",
    "number": "1053958132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 1ST ST S",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 1ST ST S",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803602",
            "telephone_number": "863-294-7487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AU-YEUNG",
        "first_name": "SO MAN AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-08",
        "last_updated": "2019-12-08",
        "certification_date": "2019-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS60050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.