Individual
ANDERSON YEH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1350 HICKORY ST STE 101, MELBOURNE, FL 32901-3224
(321) 434-1401
(321) 434-1667
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-1401
(321) 434-1667
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
9113431
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9113431
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07283
HF HFPSI
FL
01
—
07284
HF HFMG
FL
05
—
108291600
—
FL
Enumeration date
06/07/2020
Last updated
04/25/2022
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