Provider Demographics
NPI:1447797519
Name:LE, YEN (MD)
Entity Type:Individual
Prefix:DR
First Name:YEN
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6949 MIDNIGHT PASS RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34242-2611
Mailing Address - Country:US
Mailing Address - Phone:941-822-0346
Mailing Address - Fax:
Practice Address - Street 1:1750 17TH STREET BUILDING E SALLY AND SAM
Practice Address - Street 2:SHAPIRO BABIES AND CHILDREN MEDICAL CENTER
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234
Practice Address - Country:US
Practice Address - Phone:941-861-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME130680207Q00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine