Provider Demographics
NPI:1609507524
Name:YILDIZ, MERT OMER
Entity Type:Individual
Prefix:
First Name:MERT
Middle Name:OMER
Last Name:YILDIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 SW 1ST AVE APT 3316
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-4407
Mailing Address - Country:US
Mailing Address - Phone:954-952-0071
Mailing Address - Fax:
Practice Address - Street 1:301 SW 1ST AVE APT 3316
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-4407
Practice Address - Country:US
Practice Address - Phone:954-952-0071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health