Healthcare Provider Details

I. General information

NPI: 1700123841
Provider Name (Legal Business Name): LAURA ANNE YEUNG CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2013
Last Update Date: 05/05/2020
Certification Date: 05/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 PONCE DE LEON BLVD
CORAL GABLES FL
33146-2513
US

IV. Provider business mailing address

7350 SW 89TH ST #404
MIAMI FL
33156-7707
US

V. Phone/Fax

Practice location:
  • Phone: 305-689-5555
  • Fax:
Mailing address:
  • Phone: 786-423-6267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN 9258092
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN9258092
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: