Provider Demographics
NPI:1770578585
Name:VAN DER LINDE, YIRA (MD)
Entity type:Individual
Prefix:
First Name:YIRA
Middle Name:
Last Name:VAN DER LINDE
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 1:1221 E DE SOTO ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-3337
Mailing Address - Country:US
Mailing Address - Phone:850-439-2100
Mailing Address - Fax:850-439-2122
Practice Address - Street 1:1221 E DE SOTO ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-3337
Practice Address - Country:US
Practice Address - Phone:850-437-9997
Practice Address - Fax:850-439-2122
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME942422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry