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NPI Code Detail

MEDICARE: YOLANDE MARIE ECKRICH PA-C

MEDICARE:   YOLANDE MARIE ECKRICH  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant9110800FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104336783
Entity Type Code : Individual
Provider Name (Legal Business Name) : YOLANDE MARIE ECKRICH PA-C
Provider Business Mailing Address
First Line : 4600 HOLLY BRANCH DR APT 903
Second Line :
City : ORLANDO
State : FL
Zip : 32811-7117
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2504 SAND MINE RD
Second Line :
City : DAVENPORT
State : FL
Zip : 33897-3402
Country : US
Telephone Number : 863-419-7645
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2017
Last Update Date : 10/09/2017

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Directions to “ YOLANDE MARIE ECKRICH PA-C” Practice Location

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