Individual
BRIAN D YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
(813) 558-6187
Mailing address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
(813) 558-6187
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA9105927
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9105927
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003307700
—
FL
01
—
9287689
AETNA
FL
01
—
P01054195
RAILROAD MEDICARE
FL
01
—
Y06SL
BCBS
FL
Enumeration date
02/25/2011
Last updated
01/23/2015
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