Provider Demographics
NPI:1144295676
Name:ZABALA, YVONNE DENISE (DO)
Entity type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:DENISE
Last Name:ZABALA
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Gender:F
Credentials:DO
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Mailing Address - Street 1:PO BOX 44008
Mailing Address - Street 2:UFJP PROVIDER ENROLLMENT
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4008
Mailing Address - Country:US
Mailing Address - Phone:904-244-3660
Mailing Address - Fax:904-244-3425
Practice Address - Street 1:1350 S HICKORY ST
Practice Address - Street 2:HOLMES REGIONAL MED CENTER
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3278
Practice Address - Country:US
Practice Address - Phone:321-434-1491
Practice Address - Fax:321-434-8939
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-20
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
FLOS8328208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH33884Medicare UPIN