Provider Demographics
NPI:1467688101
Name:YILDIRIM, PATRICIA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:YILDIRIM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11301 N US HIGHWAY 301 STE 104
Mailing Address - Street 2:
Mailing Address - City:THONOTOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:33592-3603
Mailing Address - Country:US
Mailing Address - Phone:813-381-3061
Mailing Address - Fax:
Practice Address - Street 1:11301 N US HIGHWAY 301 STE 104
Practice Address - Street 2:
Practice Address - City:THONOTOSASSA
Practice Address - State:FL
Practice Address - Zip Code:33592-3603
Practice Address - Country:US
Practice Address - Phone:813-381-3061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104988363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant