Provider Demographics
NPI:1720274483
Name:YOVAISH, WENDY ANN (ARNP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:ANN
Last Name:YOVAISH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 W GORE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1141
Mailing Address - Country:US
Mailing Address - Phone:407-648-7802
Mailing Address - Fax:321-843-3555
Practice Address - Street 1:60 W GORE ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1141
Practice Address - Country:US
Practice Address - Phone:407-648-7802
Practice Address - Fax:321-843-3555
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1279692363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000146700Medicaid
FLARNP1279692OtherMEDICAL LICENSE
FLARNP1279692OtherMEDICAL LICENSE