| Nicole Michelle Yates, SLP | |
|
11864 Crestridge Loop, Trinity, FL 34655-0018 | |
| (813) 944-9594 | |
| Not Available |
| Full Name | Nicole Michelle Yates |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 11864 Crestridge Loop, Trinity, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821327735 | NPI | - | NPPES |
| 001700700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | SA10890 (Florida) | Primary |
| Provider Name | Bayside Speech Therapy, Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1578954962 PECOS PAC ID: 5294192175 Enrollment ID: O20230608000493 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Michelle Yates, SLP 11864 Crestridge Loop, Trinity, FL 34655-0018 Ph: (813) 944-9594 | Nicole Michelle Yates, SLP 11864 Crestridge Loop, Trinity, FL 34655-0018 Ph: (813) 944-9594 |
Mrs. Tara Nicole Gosnik, M.A., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 11863 Crestridge Loop, Trinity, FL 34655 Phone: 330-603-4714 | |
Mrs. Angela C Brock, MED.CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 10547 Peppergrass Ct, Trinity, FL 34655 Phone: 727-222-3762 | |
Mr. Vishnu Hardasmal Sujanani, MA, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 10735 Northridge Ct, Trinity, FL 34655 Phone: 727-376-9180 Fax: 727-376-9180 | |
Joleen Fernald, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2114 Seven Springs Blvd Ste 200, Trinity, FL 34655 Phone: 603-498-7825 | |
Shannon M Mahoney, M.S., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2323 Little Rd, Trinity, FL 34655 Phone: 727-774-9200 | |
Gosnik Speech Services Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 11863 Crestridge Loop, Trinity, FL 34655 Phone: 330-603-4714 | |
Casey Kylynn Stark, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 7048 Columns Cir Apt 107, Trinity, FL 34655 Phone: 952-807-3558 |