Healthcare Provider Details

I. General information

NPI: 1447416300
Provider Name (Legal Business Name): CAROL FRANCISCA YEATS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROL MCDONALD YEATS

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 07/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5917 NW 54TH WAY
GAINESVILLE FL
32653-3268
US

IV. Provider business mailing address

5917 NW 54TH WAY
GAINESVILLE FL
32653-3268
US

V. Phone/Fax

Practice location:
  • Phone: 352-377-2241
  • Fax:
Mailing address:
  • Phone: 352-377-2241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT1435
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: