Provider Demographics
NPI:1912962648
Name:YAO, JOANNA YU (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:YU
Last Name:YAO
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 1:1840 CAPITAL MEDICAL CT
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4468
Mailing Address - Country:US
Mailing Address - Phone:850-878-0550
Mailing Address - Fax:850-878-0587
Practice Address - Street 1:1840 CAPITAL MEDICAL CT
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4468
Practice Address - Country:US
Practice Address - Phone:850-878-0550
Practice Address - Fax:850-878-0587
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73550208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL41410OtherBLUE CROSS BLUE SHIELD
FL41410Medicare ID - Type Unspecified
FL41410OtherBLUE CROSS BLUE SHIELD