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5647 Gulf Dr, New Port Richey, FL 34652-4019 | |
(813) 435-3355 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Clinic/center |
Location | 5647 Gulf Dr, New Port Richey, Florida |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1578954962 | NPI | - | NPPES |
014254700 | Medicaid | FL |
Provider Name | Nicole Michelle Yates |
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Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1821327735 PECOS PAC ID: 6103283080 Enrollment ID: I20230608000694 |
Mailing Address | Practice Location Address |
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5647 Gulf Dr, New Port Richey, FL 34652-4019 Ph: (813) 435-3355 | 5647 Gulf Dr, New Port Richey, FL 34652-4019 Ph: (813) 435-3355 |