Provider Demographics
NPI:1821133935
Name:YARRINGTON, PAMELA LEANN (PA-C, MPAS)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:LEANN
Last Name:YARRINGTON
Suffix:
Gender:F
Credentials:PA-C, MPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8831 PINE BAY CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-3712
Mailing Address - Country:US
Mailing Address - Phone:407-894-6980
Mailing Address - Fax:407-894-6982
Practice Address - Street 1:725 PRIMERA BLVD STE 140
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2130
Practice Address - Country:US
Practice Address - Phone:407-732-7266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA24222084P0800X, 363A00000X
FLPAX940363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL288735OtherAMERIGROUP
FL290893000Medicaid