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General NPI Number Information
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NPI Number | 1508840604
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Entity Type | Individual
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Provider Name | MARY WILLSON YEILDING OD
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Gender | Female
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 09/17/2022
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Provider Practice Location Address
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Address Line | 215 E NEW HAMPSHIRE ST
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City | ORLANDO
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State | FL
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Zip | 32804-6403
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Country | US
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Telephone | 407-584-7207
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Fax |
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Provider Business Mailing Address
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Address Line | 2059 WOODLAWN DR
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City | ORLANDO
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State | FL
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Zip | 32803-1652
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Country | US
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Telephone | 407-222-3451
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC3389
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License Number State | FL
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