Provider Demographics
NPI:1588452429
Name:YANNI, JOSEPH F (AGACNP-BC)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:F
Last Name:YANNI
Suffix:
Gender:
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1736 ARASH CIR
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32128-7335
Mailing Address - Country:US
Mailing Address - Phone:386-585-2902
Mailing Address - Fax:
Practice Address - Street 1:770 W GRANADA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5179
Practice Address - Country:US
Practice Address - Phone:386-585-2902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11039171207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine