MEDICARE: YISEET FAJARDO DIAZ

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	RBT-24-375422	FL

General Provider Information

NPI Number	:	1275359119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YISEET FAJARDO DIAZ

Provider Business Mailing Address
First Line	:	315 PICO CT
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33809-4234
Country	:	US
Telephone Number	:	863-602-2594
Fax Number	:

Provider Business Practice Location Address
First Line	:	315 PICO CT
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33809-4234
Country	:	US
Telephone Number	:	863-602-2594
Fax Number	:

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

Provider Enumeration Date	:	11/25/2024
Last Update Date	:	06/18/2026

Similar Medicare Providers

1881862589 — PUBLIX SUPER MARKETS INC
Practice Location Address:

5185 US HIGHWAY 98 N # 5
LAKELAND, FL
33809-0531

Practice Phone: 863-644-7969
Practice Fax: 863-644-8284

1437190931 — PUBLIX SUPER MARKETS INC
Practice Location Address:

6767 US HIGHWAY 98 N
LAKELAND, FL
33809-6226

Practice Phone: 863-859-5838
Practice Fax: 863-859-6517

1790725133 — PUBLIX SUPER MARKETS INC
Practice Location Address:

5375 N SOCRUM LOOP RD
LAKELAND, FL
33809-4272

Practice Phone: 863-859-6353
Practice Fax: 863-859-3524

1053305821 — EYE EXPRESS, INC.
Practice Location Address:

5528 US 98 NORTH
LAKELAND, FL
33809-3104

Practice Phone: 863-853-2020
Practice Fax: 863-527-2008

1811982192 — PHILLIPS SALOMON & PARRISH PA
Practice Location Address:

5528 US HIGHWAY 98 N
LAKELAND, FL
33809-3104

Practice Phone: 863-853-2020
Practice Fax: 863-595-2838

1831187012 — PIUS N GODWIN ARNP
Practice Location Address:

1267 TIMBERIDGE LOOP N
LAKELAND, FL
33809-4682

Practice Phone: 863-602-7908
Practice Fax: 863-815-1901

Directions to “ YISEET FAJARDO DIAZ ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.