MEDICARE: YOLANTA D BOOKER ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	ARNP1901042	FL

General Provider Information

NPI Number	:	1578555090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLANTA D BOOKER ARNP

Provider Business Mailing Address
First Line	:	1625 SE THIRD AVENUE
Second Line	:	SUITE 400
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-2521
Country	:	US
Telephone Number	:	954-832-0055
Fax Number	:	954-832-0063

Provider Business Practice Location Address
First Line	:	1625 SE 3RD AVE
Second Line	:	SUITE 400
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33316-2521
Country	:	US
Telephone Number	:	954-832-0055
Fax Number	:	954-832-0063

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	05/19/2009

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