Healthcare Provider Details

I. General information

NPI: 1366497968
Provider Name (Legal Business Name): YAMILET NENINGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 03/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4509 N ARMENIA AVE
TAMPA FL
33603-2747
US

IV. Provider business mailing address

PO BOX 152758
TAMPA FL
33684-2758
US

V. Phone/Fax

Practice location:
  • Phone: 813-873-7777
  • Fax: 813-873-7776
Mailing address:
  • Phone: 813-873-7777
  • Fax: 813-873-7776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME87139
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME87139
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME87139
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: