Provider Demographics
NPI:1346671104
Name:YVANNE M BERRYER MD PA
Entity Type:Organization
Organization Name:YVANNE M BERRYER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OBGYN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YVANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BERRYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-247-2475
Mailing Address - Street 1:829 NE 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4720
Mailing Address - Country:US
Mailing Address - Phone:305-247-2475
Mailing Address - Fax:305-357-2499
Practice Address - Street 1:829 NE 4TH AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4720
Practice Address - Country:US
Practice Address - Phone:305-247-2475
Practice Address - Fax:305-357-2499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-04
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251422200Medicaid
FL186304OtherMEDICARE
FL186304OtherMEDICARE