Provider Demographics
NPI:1659330207
Name:MORENCY, YVES (MD)
Entity Type:Individual
Prefix:DR
First Name:YVES
Middle Name:
Last Name:MORENCY
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 1:2227 22ND ST S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-3501
Mailing Address - Country:US
Mailing Address - Phone:727-215-1148
Mailing Address - Fax:
Practice Address - Street 1:1955 US1 SOUTH
Practice Address - Street 2:SUITE 200
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086
Practice Address - Country:US
Practice Address - Phone:904-494-2841
Practice Address - Fax:904-829-0973
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0044542207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265814300Medicaid
36390XMedicare ID - Type Unspecified
FL265814300Medicaid