MEDICARE: DR. YISSELL SANCHEZ ACOSTA O.D.

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	152W00000X	Optometrist	OPC4713	FL

General Provider Information

NPI Number	:	1629325584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YISSELL SANCHEZ ACOSTA O.D.

Provider Business Mailing Address
First Line	:	3502 KYOTO GARDENS DR STE B
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-2899
Country	:	US
Telephone Number	:	561-630-7120
Fax Number	:

Provider Business Practice Location Address
First Line	:	3502 KYOTO GARDENS DR STE B
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-2899
Country	:	US
Telephone Number	:	561-630-7120
Fax Number	:

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

Provider Enumeration Date	:	08/10/2012
Last Update Date	:	04/12/2018

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