Healthcare Provider Details

I. General information

NPI: 1932658713
Provider Name (Legal Business Name): KEVIN JAMES YATES D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2016
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 W PINELOCH AVE STE 11
ORLANDO FL
32806-6100
US

IV. Provider business mailing address

102 W PINELOCH AVE STE 11
ORLANDO FL
32806-6100
US

V. Phone/Fax

Practice location:
  • Phone: 407-423-4761
  • Fax:
Mailing address:
  • Phone: 407-791-8974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH 5918
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: