Provider Demographics
NPI:1265865810
Name:BOSTON, YVONNE VIDA (MSN,ARNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:VIDA
Last Name:BOSTON
Suffix:
Gender:F
Credentials:MSN,ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E IRLO BRONSON MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-4745
Mailing Address - Country:US
Mailing Address - Phone:407-957-0900
Mailing Address - Fax:407-593-9413
Practice Address - Street 1:1000 E IRLO BRONSON MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-4745
Practice Address - Country:US
Practice Address - Phone:689-210-8100
Practice Address - Fax:407-593-9413
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9244881363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01705695OtherRAILROAD MEDICARE
FL010589800Medicaid
FLHP672XMedicare PIN