Provider Demographics
NPI:1366497968
Name:NENINGER, YAMILET (MD)
Entity type:Individual
Prefix:
First Name:YAMILET
Middle Name:
Last Name:NENINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 152758
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33684-2758
Mailing Address - Country:US
Mailing Address - Phone:813-873-7777
Mailing Address - Fax:813-873-7776
Practice Address - Street 1:4509 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-2747
Practice Address - Country:US
Practice Address - Phone:813-873-7777
Practice Address - Fax:813-873-7776
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87139207L00000X, 207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL45642OtherFGTBA GROUP BCBS
FL50737OtherFL BCBS
FL251915100Medicaid
FL262127400Medicaid
FL270843400Medicaid
FL5811585OtherFGTBA GROUP AETNA
FL40929OtherGTBA GROUP BCBS
FL5250415OtherGTBA GROUP AETNA
FL5250415OtherGTBA GROUP AETNA
FL50737OtherFL BCBS
FL5811585OtherFGTBA GROUP AETNA
FL262127400Medicaid
FL50737YMedicare ID - Type UnspecifiedFGTBA MEDICARE
FL40929Medicare ID - Type UnspecifiedGTBA GROUP MEDICARE