Provider Demographics
NPI:1417162199
Name:YIN, ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:YIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6376 PINE RIDGE RD UNIT 180
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-3926
Mailing Address - Country:US
Mailing Address - Phone:239-263-0849
Mailing Address - Fax:239-263-2376
Practice Address - Street 1:6376 PINE RIDGE RD UNIT 180
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-3926
Practice Address - Country:US
Practice Address - Phone:239-263-0849
Practice Address - Fax:239-263-2376
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME116357207RC0000X
PAMT188559207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009153800Medicaid
FLP01238894OtherRR MEDICARE
FL14T2WOtherBCBS
FL009153800Medicaid