Provider Demographics
NPI:1578780524
Name:YANEZ, FRANK JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JOHN
Last Name:YANEZ
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 1:401 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4931
Mailing Address - Country:US
Mailing Address - Phone:407-674-2044
Mailing Address - Fax:407-674-2049
Practice Address - Street 1:401 W OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4931
Practice Address - Country:US
Practice Address - Phone:407-674-2044
Practice Address - Fax:407-674-2049
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN235207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000864700Medicaid
FL0380551OtherECFMG NUMBER