Healthcare Provider Details

I. General information

NPI: 1083073571
Provider Name (Legal Business Name): YORDANYS YERA-VALLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2016
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1507 N JOHN YOUNG PKWY STE B
KISSIMMEE FL
34741-3214
US

IV. Provider business mailing address

1507 N JOHN YOUNG PKWY STE B
KISSIMMEE FL
34741-3214
US

V. Phone/Fax

Practice location:
  • Phone: 407-288-8850
  • Fax: 407-214-8850
Mailing address:
  • Phone: 407-288-8850
  • Fax: 407-214-1333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberACN1430
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: