MEDICARE: JENNIFER L YATES

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		FL

General Provider Information

NPI Number	:	1912866476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER L YATES

Provider Business Mailing Address
First Line	:	10724 BURNING BUSH TER
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-6883
Country	:	US
Telephone Number	:	813-460-6454
Fax Number	:

Provider Business Practice Location Address
First Line	:	10724 BURNING BUSH TER
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-6883
Country	:	US
Telephone Number	:	813-460-6454
Fax Number	:

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

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/21/2026

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Directions to “ JENNIFER L YATES ” Practice Location

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