Provider Demographics
NPI:1962236158
Name:HER HEALTH GYNECOLOGY, LLC
Entity type:Organization
Organization Name:HER HEALTH GYNECOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:EDEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:YELVERTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-517-1425
Mailing Address - Street 1:7028 HIGHGATE LN
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-1236
Mailing Address - Country:US
Mailing Address - Phone:601-517-1425
Mailing Address - Fax:
Practice Address - Street 1:6600 UNIVERSITY PKWY STE 305
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34240-9048
Practice Address - Country:US
Practice Address - Phone:601-517-1425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty