Healthcare Provider Details

I. General information

NPI: 1942763917
Provider Name (Legal Business Name): JONATHAN YAWMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 COLUMBIA ST STE 400
ORLANDO FL
32806-1115
US

IV. Provider business mailing address

1222 S ORANGE AVE FL 5
ORLANDO FL
32806-1215
US

V. Phone/Fax

Practice location:
  • Phone: 321-843-5851
  • Fax: 321-843-7381
Mailing address:
  • Phone: 321-841-1764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number100634
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: