Healthcare Provider Details

I. General information

NPI: 1235248006
Provider Name (Legal Business Name): JAMES E YOACHIM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 04/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 W MILLER ST
ORLANDO FL
32806-2032
US

IV. Provider business mailing address

92 W MILLER ST
ORLANDO FL
32806-2032
US

V. Phone/Fax

Practice location:
  • Phone: 407-649-9111
  • Fax: 321-841-4603
Mailing address:
  • Phone: 407-649-9111
  • Fax: 321-841-4603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME0038827
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberME38827
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: