Provider Demographics
NPI:1679701460
Name:YANG, ERICA TAYLOR (MD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:TAYLOR
Last Name:YANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7631 E MEDLOCK DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-7730
Mailing Address - Country:US
Mailing Address - Phone:610-350-6953
Mailing Address - Fax:
Practice Address - Street 1:9582 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-6992
Practice Address - Country:US
Practice Address - Phone:407-896-3055
Practice Address - Fax:407-826-1103
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1341782085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME134178OtherFL LICENSE
2085R0202XOtherTAXONOMY