Provider Demographics
NPI:1205845757
Name:DUVAL, YANIQUE (MD)
Entity Type:Individual
Prefix:
First Name:YANIQUE
Middle Name:
Last Name:DUVAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YANIQUE
Other - Middle Name:
Other - Last Name:BRUNOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2247 PALM BEACH LAKES BLVD
Mailing Address - Street 2:STE. 103
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3470
Mailing Address - Country:US
Mailing Address - Phone:561-687-1304
Mailing Address - Fax:561-687-1306
Practice Address - Street 1:2247 PALM BEACH LAKES BLVD
Practice Address - Street 2:STE. 103
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3470
Practice Address - Country:US
Practice Address - Phone:561-687-1304
Practice Address - Fax:561-687-1306
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME925872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry