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General NPI Number Information
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NPI Number | 1750105201
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Entity Type | Organization
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Legal Business Name | YPD WELLNESS INC
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 2146 S RIVERSIDE DR STE 8
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City | EDGEWATER
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State | FL
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Zip | 32141-4257
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Country | US
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Telephone | 305-334-6235
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Fax |
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Provider Business Mailing Address
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Address Line | 2146 S RIVERSIDE DR STE 8
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City | EDGEWATER
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State | FL
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Zip | 32141-4257
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YOSVANY PEREZ
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Credential |
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Telephone | 863-347-0075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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