Healthcare Provider Details

I. General information

NPI: 1780598318
Provider Name (Legal Business Name): YANEISI DE LA VEGA GIL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10305 NW 41ST ST STE 227
DORAL FL
33178-2976
US

IV. Provider business mailing address

7215 NW 173RD DR APT 1002
HIALEAH FL
33015-8401
US

V. Phone/Fax

Practice location:
  • Phone: 305-617-2583
  • Fax:
Mailing address:
  • Phone: 786-329-3378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9664384
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: