Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 9259871 | FL |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 9259871 | FL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 9259871 | FL |
NPI | 1275944696 |
---|---|
Provider Name | Yara C. Agostini |
First Address | Palm Coast, FL 32164-6855 |
Second Address | Ormond Beach, FL 32174-6264 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2014 |
Last Update Date | 25/09/2018 |