Basic Information
Provider Information
NPI: 1871569285
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NOFSINGER
FirstName: YOON
MiddleName: C
NamePrefix: DR.
NameSuffix:  
Credential: MD, PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: SELECT PHYSICIANS ALLIANCE
Address2: 10002 PRINCESS PALM AVE. STE 332
City: TAMPA
State: FL
PostalCode: 336198327
CountryCode: US
TelephoneNumber: 8135717184
FaxNumber: 8136544695
Practice Location
Address1: FLORIDA ENT & ALLERGY
Address2: 3000 MEDICAL PARK DR. STE 200
City: TAMPA
State: FL
PostalCode: 336134695
CountryCode: US
TelephoneNumber: 8138798045
FaxNumber: 8139783667
Other Information
ProviderEnumerationDate: 02/25/2006
LastUpdateDate: 05/07/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Y00000XME81539FLY Allopathic & Osteopathic PhysiciansOtolaryngology 

ID Information
IDTypeStateIssuerDescription
P0075594301FLMEDICARE RAILROADOTHER
27990810005FL MEDICAID


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