| Rene Yates, PA | |
|
8390 Champions Gate Blvd, Suite 306, Champions Gate, FL 33896-8310 | |
| (407) 390-1677 | |
| (407) 390-1765 |
| Full Name | Rene Yates |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 8390 Champions Gate Blvd, Champions Gate, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558638700 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA9106224 (Florida) | Primary |
| Entity Name | Polk Emergency Group LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558338574 PECOS PAC ID: 0547241598 Enrollment ID: O20050506000658 |
| Entity Name | Lake Wales Emergency Physicians, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033480405 PECOS PAC ID: 8022270461 Enrollment ID: O20120502000079 |
| Mailing Address | Practice Location Address |
|---|---|
| Rene Yates, PA 8390 Champions Gate Blvd, Suite 306, Champions Gate, FL 33896-8310 Ph: (407) 390-1677 | Rene Yates, PA 8390 Champions Gate Blvd, Suite 306, Champions Gate, FL 33896-8310 Ph: (407) 390-1677 |
Mrs. Kimberly Ann Jerome, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1485 Legends Blvd, Champions Gate, FL 33896 Phone: 407-390-6480 Fax: 407-390-6483 |
Stefani Jo Heisler, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 8390 Champions Gate Blvd, Suite 306, Champions Gate, FL 33896 Phone: 407-390-1677 Fax: 407-390-1765 |
Joseph Califano Ii, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 8390 Champions Gate Blvd Ste 306, Champions Gate, FL 33896 Phone: 407-222-9680 |