MEDICARE: YANET OSORIO RIQUENES NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	APRN11026469	FL
2	363LA2200X	Adult Health Nurse Practitioner	11026469	FL
3	163W00000X	Registered Nurse	715021	NY
4	363LA2200X	Adult Health Nurse Practitioner	310475	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184173551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANET OSORIO RIQUENES NP

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-424-2757
Fax Number	:	239-772-0186

Provider Business Practice Location Address
First Line	:	1435 SE 8TH TER STE E
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-3289
Country	:	US
Telephone Number	:	239-424-2757
Fax Number	:	239-772-0186

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2016
Last Update Date	:	03/16/2026

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