Provider Demographics
NPI:1134235617
Name:YORKE, VICTORIA L (MD)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:L
Last Name:YORKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-495-4490
Mailing Address - Fax:239-495-4491
Practice Address - Street 1:26800 S TAMIAMI TRL
Practice Address - Street 2:SUITE 340
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-4349
Practice Address - Country:US
Practice Address - Phone:239-495-4490
Practice Address - Fax:239-495-4491
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI35336207Q00000X
FLME124578207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015214100Medicaid
WI32027900Medicaid
WIE23962Medicare UPIN