Provider Demographics
NPI:1093748204
Name:CHAMBLIN, YOLAINE M (MD)
Entity Type:Individual
Prefix:
First Name:YOLAINE
Middle Name:M
Last Name:CHAMBLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10280 PINES BLVD STE P701
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-6057
Mailing Address - Country:US
Mailing Address - Phone:954-323-8446
Mailing Address - Fax:954-323-8207
Practice Address - Street 1:10280 PINES BLVD STE P701
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-6057
Practice Address - Country:US
Practice Address - Phone:954-323-8446
Practice Address - Fax:954-323-8207
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88893207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU2485DOtherMEDICARE ID
FL2699943500Medicaid
FLH59677Medicare UPIN