Provider Demographics
NPI:1578555090
Name:BOOKER, YOLANTA D (ARNP)
Entity Type:Individual
Prefix:
First Name:YOLANTA
Middle Name:D
Last Name:BOOKER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 SE THIRD AVENUE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2521
Mailing Address - Country:US
Mailing Address - Phone:954-832-0055
Mailing Address - Fax:954-832-0063
Practice Address - Street 1:1625 SE 3RD AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2521
Practice Address - Country:US
Practice Address - Phone:954-832-0055
Practice Address - Fax:954-832-0063
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1901042207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q40560Medicare UPIN