Healthcare Provider Details

I. General information

NPI: 1184885691
Provider Name (Legal Business Name): ARLO H YAEGE D.P.M
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 04/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 MILUS ST FOOT AND ANKLE CENTER OF CHARLOTTE COUNTY
PUNTA GORDA FL
33950-4552
US

IV. Provider business mailing address

352 MILUS ST FOOT AND ANKLE CENTERS OF CHARLOTTE COUNTY
PUNTA GORDA FL
33950-4552
US

V. Phone/Fax

Practice location:
  • Phone: 941-639-0025
  • Fax: 941-347-7271
Mailing address:
  • Phone: 941-639-0025
  • Fax: 941-347-7271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC005945
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO3380
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: