MEDICARE: YARIELIS NOA

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	103K00000X	Behavior Analyst	1-26-89785	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	:	1447984034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YARIELIS NOA

Provider Business Mailing Address
First Line	:	3301 SHELLEY DR
Second Line	:
City	:	GREEN COVE SPRINGS
State	:	FL
Zip	:	32043-5237
Country	:	US
Telephone Number	:	786-623-8176
Fax Number	:

Provider Business Practice Location Address
First Line	:	12724 GRAN BAY PKWY W STE 410
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-9486
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

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

Provider Enumeration Date	:	07/11/2022
Last Update Date	:	05/08/2026

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Directions to “ YARIELIS NOA ” Practice Location

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