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Individual

MITCHELL W. YADVEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 3RD AVE W, SUITE 210, BRADENTON, FL 34205-8626
(941) 792-0340
(941) 794-2251
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME0073485
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
012776300
FL
01
09135
UNIVERSAL HEALTHCARE
FL
01
1193524
WELLCARE
FL
01
353796
AVMED
FL
01
41687
BCBS FL
FL
01
5836692
AETNA
FL
01
P01040604
RAILROAD MCR
FL
01
P01805322
CLEAR HEALTH
FL
01
P102258
FREEDOM HEALTH
FL
01
P933155
OPTIMUM
FL
Enumeration date
07/05/2006
Last updated
04/12/2017
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