Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 52129 | MN |
N | 111NI0900X | Internist | 52129 | MN |
Y | 207RG0100X | Gastroenterologist | ME124184 | FL |
N | 207RG0100X | Gastroenterologist | TRN15877 | FL |
NPI | 1013165182 |
---|---|
Provider Name | Dennis Yang |
First Address | Winter Park, FL 32789-1238 |
Second Address | Orlando, FL 32803-1248 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2008 |
Last Update Date | 23/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
015492000 | (05) | FL |
ENROLLED | (05) | MN |