Provider Demographics
NPI:1528747367
Name:JESTER, YOLANDA M
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:M
Last Name:JESTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11365 SW 226TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33170-6422
Mailing Address - Country:US
Mailing Address - Phone:144-337-8948
Mailing Address - Fax:
Practice Address - Street 1:11365 SW 226TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-6422
Practice Address - Country:US
Practice Address - Phone:443-378-9486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities