Individual
MISS YESENIA BORESOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7529 MEDICAL DR, HUDSON, FL 34667-6502
(727) 862-6524
(727) 862-6439
Mailing address
7529 MEDICAL DR, HUDSON, FL 34667-6502
(727) 862-6524
(727) 862-6439
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
085.003647
IL
363AM0700X
Medical Physician Assistant
Primary
20969
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA 9107742
FLORIDA LICENSE NUMBER
FL
Enumeration date
11/03/2009
Last updated
04/07/2014
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