Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | ME55059 | FL |
NPI | 1003801135 |
---|---|
Provider Name | Timothy Raymond Yeko |
First Address | Tampa, FL 33617-1126 |
Second Address | Tampa, FL 33617-1126 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2005 |
Last Update Date | 23/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C46686 | (02) |