MEDICARE: EMILY YI

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	1041C0700X	Clinical Social Worker

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	:	1801150701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY YI

Provider Business Mailing Address
First Line	:	3995 HUNT CLUB RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32224-8416
Country	:	US
Telephone Number	:	904-434-4233
Fax Number	:	877-370-7409

Provider Business Practice Location Address
First Line	:	3995 HUNT CLUB RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32224-8416
Country	:	US
Telephone Number	:	904-434-4233
Fax Number	:	877-370-7409

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

Provider Enumeration Date	:	06/26/2012
Last Update Date	:	07/16/2024

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Directions to “ EMILY YI ” Practice Location

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