Healthcare Provider Details

I. General information

NPI: 1750640751
Provider Name (Legal Business Name): YVON PETIOTE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2012
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date: 05/28/2026
Reactivation Date: 06/29/2026

III. Provider practice location address

5100 COCONUT CREEK PKWY
MARGATE FL
33063-3913
US

IV. Provider business mailing address

2800 S SEACREST BLVD STE 140
BOYNTON BEACH FL
33435-7943
US

V. Phone/Fax

Practice location:
  • Phone: 954-281-7700
  • Fax:
Mailing address:
  • Phone: 561-739-9187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME125552
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: