MEDICARE: AGUSTIN JULIEN YANES SR.

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

General Provider Information

NPI Number	:	1275477093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AGUSTIN JULIEN YANES SR.

Provider Business Mailing Address
First Line	:	7130 SW 4TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2606
Country	:	US
Telephone Number	:	786-868-9395
Fax Number	:

Provider Business Practice Location Address
First Line	:	7130 SW 4TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2606
Country	:	US
Telephone Number	:	786-868-9395
Fax Number	:

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

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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