Provider Demographics
NPI:1700024833
Name:TIVOLI, YVETTE ARLENE (DO)
Entity Type:Individual
Prefix:DR
First Name:YVETTE
Middle Name:ARLENE
Last Name:TIVOLI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16244 S MILITARY TRL STE 490
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6532
Mailing Address - Country:US
Mailing Address - Phone:561-802-7546
Mailing Address - Fax:561-802-7546
Practice Address - Street 1:16244 S MILITARY TRL STE 490
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484
Practice Address - Country:US
Practice Address - Phone:561-802-7546
Practice Address - Fax:561-802-7546
Is Sole Proprietor?:No
Enumeration Date:2009-01-28
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10758207N00000X, 207NS0135X, 207Q00000X
WAOP60804168207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS10758OtherMEDICAL LICENSE