Provider Demographics
NPI:1194909358
Name:SHAKES, YVONNE E
Entity type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:E
Last Name:SHAKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YVONNE
Other - Middle Name:E
Other - Last Name:SHAKES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5738 HORTON RD
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33567-3740
Mailing Address - Country:US
Mailing Address - Phone:813-737-2899
Mailing Address - Fax:813-650-8654
Practice Address - Street 1:5738 HORTON RD
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33567-3740
Practice Address - Country:US
Practice Address - Phone:813-737-2899
Practice Address - Fax:813-650-8654
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL229803372600000X, 376J00000X
FL372500000X, 3747P1801X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker
No372500000XNursing Service Related ProvidersChore Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant