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General NPI Number Information
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NPI Number | 1982134797
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Entity Type | Organization
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Legal Business Name | YANNUCCI MEDICAL, PLLC
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2523 US HIGHWAY 27 S STE 130
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City | AVON PARK
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State | FL
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Zip | 33825-9690
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Country | US
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Telephone | 863-657-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 2523 US HIGHWAY 27 S STE 130
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City | AVON PARK
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State | FL
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Zip | 33825-9690
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Country | US
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Telephone | 863-657-2300
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Fax |
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | DR. JOHN JOSEPH YANNUCCI II
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Credential | MD
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Telephone | 863-657-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME92786
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License Number State | FL
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