MEDICARE: CAMILA YEPES PA-C

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	363A00000X	Physician Assistant	PA9112898	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OU530	OTHER	FL	MEDICARE PTAN

Other Identifiers

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

General Provider Information

NPI Number	:	1093331985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMILA YEPES PA-C

Provider Business Mailing Address
First Line	:	2845 PGA BLVD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-2910
Country	:	US
Telephone Number	:	561-693-0540
Fax Number	:	561-296-6174

Provider Business Practice Location Address
First Line	:	7605 CONROY WINDERMERE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-2646
Country	:	US
Telephone Number	:	321-244-6799
Fax Number	:	401-613-5915

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

Provider Enumeration Date	:	06/17/2020
Last Update Date	:	10/04/2022

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Directions to “ CAMILA YEPES PA-C” Practice Location

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