Provider Demographics
NPI:1528594488
Name:PITHON, YVROSE (LPN)
Entity Type:Individual
Prefix:
First Name:YVROSE
Middle Name:
Last Name:PITHON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6925 TURTLE BAY TER
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-7389
Mailing Address - Country:US
Mailing Address - Phone:561-386-8717
Mailing Address - Fax:
Practice Address - Street 1:6925 TURTLE BAY TER
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-7389
Practice Address - Country:US
Practice Address - Phone:561-386-8717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5182343164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL$$$$$$$$$Medicaid