Individual
DR. ROBERTO J. YCAZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2105 MANATEE AVE E, BRADENTON, FL 34208-1640
(941) 803-8395
(941) 803-8158
Mailing address
2105 MANATEE AVE E, BRADENTON, FL 34208-1640
(941) 803-8395
(941) 803-8158
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
ME66839
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201862196
TAX IDENTIFICATION
FL
05
—
271586400
—
FL
Enumeration date
03/31/2006
Last updated
07/21/2015
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