Active NPI
Yazan Eberhart
- Developmental Therapist
- Crestview, FL
National Provider Identifier
1134082217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 755 Lime LN
Crestview, FL 32536-2260 - Phone
- (954) 310-5201
- NPI assigned
- Dec 5, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | FL | Primary |
Addresses
Primary practice location
755 Lime LN
Crestview, FL 32536-2260
Mailing address
755 Lime LN
Crestview, FL 32536-2260
Phone (954) 310-5201
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1764892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764892800000",
"number": "1134082217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 LIME LN",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325362260",
"telephone_number": "954-310-5201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 LIME LN",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325362260",
"telephone_number": "954-310-5201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBERHART",
"first_name": "YAZAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-12-05",
"last_updated": "2025-12-05",
"certification_date": "2025-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crestview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.