Healthcare Provider Details

I. General information

NPI: 1720274483
Provider Name (Legal Business Name): WENDY ANN YOVAISH ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2007
Last Update Date: 07/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 W GORE ST
ORLANDO FL
32806-1141
US

IV. Provider business mailing address

60 W GORE ST
ORLANDO FL
32806-1141
US

V. Phone/Fax

Practice location:
  • Phone: 407-648-7802
  • Fax: 321-843-3555
Mailing address:
  • Phone: 407-648-7802
  • Fax: 321-843-3555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP1279692
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: