Healthcare Provider Details

I. General information

NPI: 1427494483
Provider Name (Legal Business Name): YEILDING M.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2013
Last Update Date: 05/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 W MORSE BLVD
WINTER PARK FL
32789-4294
US

IV. Provider business mailing address

328 W MORSE BLVD
WINTER PARK FL
32789-4294
US

V. Phone/Fax

Practice location:
  • Phone: 855-963-3223
  • Fax: 407-960-1001
Mailing address:
  • Phone: 855-963-3223
  • Fax: 407-960-1001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME108894
License Number StateFL

VIII. Authorized Official

Name: DR. RUTH H YEILDING
Title or Position: PRESIDENT
Credential: M.D.
Phone: 855-963-3223