Provider Demographics
NPI:1376344176
Name:YOAKUM, COLE
Entity type:Individual
Prefix:
First Name:COLE
Middle Name:
Last Name:YOAKUM
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 MOBBLY BAY DR
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-4008
Mailing Address - Country:US
Mailing Address - Phone:727-348-6004
Mailing Address - Fax:
Practice Address - Street 1:175 MOBBLY BAY DR
Practice Address - Street 2:
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-4008
Practice Address - Country:US
Practice Address - Phone:727-348-6004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program