1376874362 NPI number — Y & P HEALTHCARE LLC

Table of content: (NPI 1376874362)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376874362 NPI number — Y & P HEALTHCARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Y & P HEALTHCARE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376874362
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3524 TAMIAMI TRL
Provider Second Line Business Mailing Address:
SUTIE 103
Provider Business Mailing Address City Name:
PORT CHARLOTTE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33952-8100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-625-1801
Provider Business Mailing Address Fax Number:
941-391-6796

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3524 TAMIAMI TRL
Provider Second Line Business Practice Location Address:
SUTIE 103
Provider Business Practice Location Address City Name:
PORT CHARLOTTE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33952-8100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-625-1801
Provider Business Practice Location Address Fax Number:
941-391-6796
Provider Enumeration Date:
01/15/2010

Additional Information

Authorized Official

Authorized Official Last Name:
LEROUX
Authorized Official First Name:
PIERRE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
941-625-1801

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  ME100694 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000N8 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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