Provider Demographics
NPI:1124164918
Name:WIND, YVONNE FRANCIS (PA)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:FRANCIS
Last Name:WIND
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 WILTON DR
Mailing Address - Street 2:
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33305-1202
Mailing Address - Country:US
Mailing Address - Phone:954-567-5898
Mailing Address - Fax:
Practice Address - Street 1:1613 ALTON RD
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-2420
Practice Address - Country:US
Practice Address - Phone:305-538-1400
Practice Address - Fax:305-538-6803
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA3090363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL290888300Medicaid
FLE4919YMedicare ID - Type Unspecified
FL290888300Medicaid