Provider Demographics
NPI:1023544038
Name:YVROSE PITHON
Entity Type:Organization
Organization Name:YVROSE PITHON
Other - Org Name:YVROSE PITHON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:YVROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:PITHON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:561-386-8717
Mailing Address - Street 1:6925 TURTLE BAY TER
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-7389
Mailing Address - Country:US
Mailing Address - Phone:561-386-8717
Mailing Address - Fax:
Practice Address - Street 1:6925 TURTLE BAY TER
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-7389
Practice Address - Country:US
Practice Address - Phone:561-386-8717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========Medicaid