MEDICARE: PETER LOUIS YACINO

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	225700000X	Massage Therapist	MA75867	FL

General Provider Information

NPI Number	:	1609389741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER LOUIS YACINO

Provider Business Mailing Address
First Line	:	4394 BADALI RD
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34286-9233
Country	:	US
Telephone Number	:	941-320-2647
Fax Number	:

Provider Business Practice Location Address
First Line	:	4394 BADALI RD
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34286-9233
Country	:	US
Telephone Number	:	941-320-2647
Fax Number	:

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

Provider Enumeration Date	:	11/12/2017
Last Update Date	:	05/24/2026

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Directions to “ PETER LOUIS YACINO ” Practice Location

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