Healthcare Provider Details

I. General information

NPI: 1275707572
Provider Name (Legal Business Name): JOSHUA YORGASON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2008
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 DON WICKHAM DR STE 215
CLERMONT FL
34711-1977
US

IV. Provider business mailing address

15280 NW 79TH CT STE 200
MIAMI LAKES FL
33016-5873
US

V. Phone/Fax

Practice location:
  • Phone: 352-394-8808
  • Fax:
Mailing address:
  • Phone: 305-558-3724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number60589
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number60589
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberME164612
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: