MEDICARE: YANELYS ACOSTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-20-127814	FL
2	106S00000X	Behavior Technician		FL
3	106S00000X	Behavior Technician	A200-960-82-560-0	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275142374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANELYS ACOSTA

Provider Business Mailing Address
First Line	:	2711 EXCHANGE CT
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-4017
Country	:	US
Telephone Number	:	800-613-1303
Fax Number	:

Provider Business Practice Location Address
First Line	:	2711 EXCHANGE CT
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-4017
Country	:	US
Telephone Number	:	800-613-1303
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2020
Last Update Date	:	07/24/2020

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Directions to “ YANELYS ACOSTA ” Practice Location

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