Provider Demographics
NPI:1689641912
Name:YEPES, JULIAN (MD)
Entity Type:Individual
Prefix:
First Name:JULIAN
Middle Name:
Last Name:YEPES
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 1:501 GLADES RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-1419
Mailing Address - Country:US
Mailing Address - Phone:561-362-4400
Mailing Address - Fax:754-551-5491
Practice Address - Street 1:501 GLADES RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-1419
Practice Address - Country:US
Practice Address - Phone:561-362-4400
Practice Address - Fax:754-551-5491
Is Sole Proprietor?:No
Enumeration Date:2006-03-06
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92787207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272558400Medicaid
FL272558400Medicaid
FL05490YMedicare ID - Type Unspecified