Provider Demographics
NPI:1700194164
Name:FLORYANZIA, YUVONNE A (LMBT)
Entity Type:Individual
Prefix:
First Name:YUVONNE
Middle Name:A
Last Name:FLORYANZIA
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 252
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27331-0252
Mailing Address - Country:US
Mailing Address - Phone:919-499-8853
Mailing Address - Fax:
Practice Address - Street 1:707 CARTHAGE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4108
Practice Address - Country:US
Practice Address - Phone:919-499-8853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLMBT#5580225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
27-1431056OtherBCBS