Healthcare Provider Details

I. General information

NPI: 1396718656
Provider Name (Legal Business Name): JON YENARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 CATTLEMEN RD STE 200
SARASOTA FL
34232-6058
US

IV. Provider business mailing address

3333 CATTLEMEN RD STE 200
SARASOTA FL
34232-6058
US

V. Phone/Fax

Practice location:
  • Phone: 941-379-1700
  • Fax: 941-379-1717
Mailing address:
  • Phone: 941-379-1700
  • Fax: 941-379-1717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME87923
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: