=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760956288
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HELEN EDITH YAWORSKI MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/17/2019
-----------------------------------------------------
Last Update Date | 07/28/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | BAYONET POINT EMERGENCY DEPARTMENT 14000 FIVAY RD
-----------------------------------------------------
City | HUDSON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34667
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-819-2929
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2687 WATERS EDGE CT
-----------------------------------------------------
City | DUNEDIN
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34698-9205
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 204-250-7177
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | ME133904
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------