Yattaw, Keith I

Yattaw, Keith I is an individual health care provider with primary practice located at 1401 W Seminole Blvd , Sanford FL 32771-6743. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Yattaw, Keith I can be contacted via phone (407) 846-2266.

Contact Information

Primary practice address
1401 W Seminole Blvd Sanford FL 32771-6743
Phone: (407) 846-2266
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1588872824
LBN Legal business name Yattaw, Keith I
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2007
Last updated Apr 11th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588872824 NPPES
Florida MEDICAID 2907333000

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