Provider Demographics
NPI:1497478432
Name:SADDLER-SMITH, YVONNE DENISE (LPN)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:DENISE
Last Name:SADDLER-SMITH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:YVONNE
Other - Middle Name:DENISE
Other - Last Name:SADDLER-SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN
Mailing Address - Street 1:PO BOX 784916
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34778-4916
Mailing Address - Country:US
Mailing Address - Phone:407-506-6767
Mailing Address - Fax:
Practice Address - Street 1:730 COURTLAND ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-1316
Practice Address - Country:US
Practice Address - Phone:407-506-6767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-23
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5178544164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1497478432Medicaid