Provider Demographics
NPI:1942322953
Name:YATES, WANDA (RRT)
Entity Type:Individual
Prefix:MS
First Name:WANDA
Middle Name:
Last Name:YATES
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7498 NW 48TH CT
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-3400
Mailing Address - Country:US
Mailing Address - Phone:954-326-8444
Mailing Address - Fax:954-578-6612
Practice Address - Street 1:7498 NW 48TH CT
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-3400
Practice Address - Country:US
Practice Address - Phone:954-326-8444
Practice Address - Fax:954-578-6612
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT2456227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered