MEDICARE: YANET QUILES APRN,PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	11021066	FL
2	363LF0000X	Family Nurse Practitioner	APRN11021066	FL
3	363LF0000X	Family Nurse Practitioner	11021066	FL

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	:	1841926276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANET QUILES APRN,PMHNP

Provider Business Mailing Address
First Line	:	11329 CLAYRIDGE DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33635-1559
Country	:	US
Telephone Number	:	813-952-3801
Fax Number	:

Provider Business Practice Location Address
First Line	:	6101 WEBB RD STE 306
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-2866
Country	:	US
Telephone Number	:	813-502-2990
Fax Number	:	813-305-3077

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

Provider Enumeration Date	:	07/27/2022
Last Update Date	:	05/01/2026

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