Organization
NORTH FLORIDA ID P L
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT W. YANCEY JR. M.D. (PRESIDENT)
(352) 375-0819
Entity
Organization
Contact information
Practice address
7257 NW 4TH BLVD, #43, GAINESVILLE, FL 32607-1600
(352) 375-0819
(352) 373-6775
Mailing address
7257 NW 4TH BLVD, #43, GAINESVILLE, FL 32607-1600
(352) 375-0819
(352) 373-6775
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0045380
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME0045380
MEDICAL LICENSE
FL
Enumeration date
05/01/2007
Last updated
08/03/2007
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