Healthcare Provider Details

I. General information

NPI: 1689641912
Provider Name (Legal Business Name): JULIAN YEPES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2006
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 GLADES RD
BOCA RATON FL
33432-1419
US

IV. Provider business mailing address

501 GLADES RD
BOCA RATON FL
33432-1419
US

V. Phone/Fax

Practice location:
  • Phone: 561-362-4400
  • Fax: 754-551-5491
Mailing address:
  • Phone: 561-362-4400
  • Fax: 754-551-5491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME92787
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: