Healthcare Provider Details

I. General information

NPI: 1730028457
Provider Name (Legal Business Name): YAMELIS MARTINEZ HABER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 SW 216TH ST
CUTLER BAY FL
33190-1003
US

IV. Provider business mailing address

10300 SW 216TH ST
CUTLER BAY FL
33190-1003
US

V. Phone/Fax

Practice location:
  • Phone: 305-253-5100
  • Fax:
Mailing address:
  • Phone: 305-253-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11046396
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: