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General NPI Number Information
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NPI Number | 1831535319
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Entity Type | Organization
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Legal Business Name | DEEPER HEALTH, P.A.
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Dates
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Enumeration Date | 05/10/2013
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Last Update Date | 10/18/2013
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Provider Practice Location Address
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Address Line | 4005 BOBBIN BROOK CIR
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City | TALLAHASSEE
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State | FL
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Zip | 32312-1258
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Country | US
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Telephone | 850-296-9254
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Fax |
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Provider Business Mailing Address
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Address Line | 4005 BOBBIN BROOK CIR
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City | TALLAHASSEE
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State | FL
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Zip | 32312-1258
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Country | US
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Telephone | 850-296-9254
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JESSICA YOON
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Credential | M.D.
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Telephone | 850-296-9254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME 108361
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License Number State | FL
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