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NPI Code Detail

MEDICARE: YVONNE VIDA BOSTON MSN,ARNP, FNP-C

MEDICARE: YVONNE VIDA BOSTON MSN,ARNP, FNP-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
1363LF0000XFamily Nurse PractitionerARNP 9244881FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01705695OTHERFLRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265865810
Entity Type Code : Individual
Provider Name (Legal Business Name) : YVONNE VIDA BOSTON MSN,ARNP, FNP-C
Provider Business Mailing Address
First Line : 1000 E IRLO BRONSON MEMORIAL HWY
Second Line :
City : SAINT CLOUD
State : FL
Zip : 34769-4745
Country : US
Telephone Number : 407-957-0900
Fax Number : 407-593-9413
Provider Business Practice Location Address
First Line : 1000 E IRLO BRONSON MEMORIAL HWY
Second Line :
City : SAINT CLOUD
State : FL
Zip : 34769-4745
Country : US
Telephone Number : 689-210-8100
Fax Number : 407-593-9413
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2013
Last Update Date : 08/12/2021

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