Provider Demographics
NPI:1346253424
Name:ANDRADE, YENY WALESKA (MD)
Entity Type:Individual
Prefix:DR
First Name:YENY
Middle Name:WALESKA
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 E HWY 50 STE B
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-5189
Mailing Address - Country:US
Mailing Address - Phone:352-241-0549
Mailing Address - Fax:352-242-9325
Practice Address - Street 1:1735 E HWY 50 STE B
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-5189
Practice Address - Country:US
Practice Address - Phone:352-241-0549
Practice Address - Fax:352-242-9325
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95577207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276363000Medicaid
FLAQ205VMedicare PIN