MEDICARE: YAJAIDA ARISTHYL ARNP

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	363L00000X	Nurse Practitioner	ARNP9241385	FL

General Provider Information

NPI Number	:	1245479005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAJAIDA ARISTHYL ARNP

Provider Business Mailing Address
First Line	:	4650 S CLEVELAND AVE STE 15A
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1371
Country	:	US
Telephone Number	:	239-689-7411
Fax Number	:	239-766-7753

Provider Business Practice Location Address
First Line	:	4650 S CLEVELAND AVE STE 15A
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1371
Country	:	US
Telephone Number	:	239-689-7411
Fax Number	:	239-766-7753

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

Provider Enumeration Date	:	02/18/2009
Last Update Date	:	07/23/2024

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