Provider Demographics
NPI:1184740110
Name:YOGANAND, SHASHI YUVRAJ (MD)
Entity type:Individual
Prefix:
First Name:SHASHI
Middle Name:YUVRAJ
Last Name:YOGANAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 E ALTAMONTE DR STE 1000
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4403
Mailing Address - Country:US
Mailing Address - Phone:407-349-7917
Mailing Address - Fax:407-205-1060
Practice Address - Street 1:303 E ALTAMONTE DR STE 1000
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-4403
Practice Address - Country:US
Practice Address - Phone:407-349-7917
Practice Address - Fax:407-205-1060
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL 29069207Q00000X
FLME107493207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003124200Medicaid
FLDQ356ZMedicare PIN