MEDICARE: YOLAINE MAYEA VARGAS

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	22-232814	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1306568555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLAINE MAYEA VARGAS

Provider Business Mailing Address
First Line	:	4203 SW HIGH MEADOWS AVE
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-3726
Country	:	US
Telephone Number	:	722-225-5560
Fax Number	:

Provider Business Practice Location Address
First Line	:	703 SILVERSTREAM CIR
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34946-8921
Country	:	US
Telephone Number	:	813-573-2244
Fax Number	:

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

Provider Enumeration Date	:	09/14/2022
Last Update Date	:	09/14/2022

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