Basic Information
| Provider Information | |||||||||
| NPI: | 1871928911 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KORADIYA | ||||||||
| FirstName: | YOGESH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8569 | ||||||||
| Address2: | |||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 341018569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2396240437 | ||||||||
| FaxNumber: | 2396240464 | ||||||||
| Practice Location | |||||||||
| Address1: | 350 7TH ST N | ||||||||
| Address2: | |||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 341025754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2396243997 | ||||||||
| FaxNumber: | 2396248101 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2013 | ||||||||
| LastUpdateDate: | 04/02/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 04/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | ME126400 | FL | N | Allopathic & Osteopathic Physicians | Family Medicine | 208M00000X | ME126400 | FL | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 0VXJ3 | 01 | FL | FLORIDA BLUE | OTHER | 019102700 | 05 | FL | MEDICAID |