Healthcare Provider Details

I. General information

NPI: 1003899170
Provider Name (Legal Business Name): PEDRO N. YEPES-HOYOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 08/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 SAXON BLVD DEPT. OF PATHOLOGY
ORANGE CITY FL
32763-8468
US

IV. Provider business mailing address

PO BOX 144333
ORLANDO FL
32814-4333
US

V. Phone/Fax

Practice location:
  • Phone: 386-851-5000
  • Fax: 386-917-5159
Mailing address:
  • Phone: 407-422-9831
  • Fax: 407-648-2065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberME73487
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: