MEDICARE: YASMANY AVILA BALMASEDA APRN/FNP-C

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	363LF0000X	Family Nurse Practitioner	APRN11041940	FL

General Provider Information

NPI Number	:	1780563247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YASMANY AVILA BALMASEDA APRN/FNP-C

Provider Business Mailing Address
First Line	:	3660 CENTRAL AVE STE 9
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-8258
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3660 CENTRAL AVE STE 9
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-8258
Country	:	US
Telephone Number	:	786-712-0154
Fax Number	:

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

Provider Enumeration Date	:	08/28/2025
Last Update Date	:	11/05/2025

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