MEDICARE: YOLANDA APODACA

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	3747A0650X	Attendant Care Provider	AL9456H	AZ

General Provider Information

NPI Number	:	1134538440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLANDA APODACA

Provider Business Mailing Address
First Line	:	1621 N SILVERBELL RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-1816
Country	:	US
Telephone Number	:	520-622-0488
Fax Number	:	520-622-0487

Provider Business Practice Location Address
First Line	:	1621 N SILVERBELL RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-1816
Country	:	US
Telephone Number	:	520-622-0488
Fax Number	:	520-622-0487

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

Provider Enumeration Date	:	08/12/2014
Last Update Date	:	08/12/2014

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Directions to “ YOLANDA APODACA ” Practice Location

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