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NPI Code Detail

MEDICARE: ROBERT LEONARD YELKEN P.A.

MEDICARE: ROBERT LEONARD YELKEN P.A.
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
1363A00000XPhysician AssistantPA2550FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295741221
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT LEONARD YELKEN P.A.
Provider Business Mailing Address
First Line : PO BOX 606
Second Line :
City : GLEN ST MARY
State : FL
Zip : 32040-0606
Country : US
Telephone Number : 386-755-5044
Fax Number : 386-755-2518
Provider Business Practice Location Address
First Line : 789 W DUVAL ST
Second Line :
City : LAKE CITY
State : FL
Zip : 32055-3811
Country : US
Telephone Number : 386-755-1546
Fax Number : 386-755-2283
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 10/28/2008

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