Healthcare Provider Details

I. General information

NPI: 1851763288
Provider Name (Legal Business Name): YENIXIS MARTINEZ-CASTILLO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2015
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 E HALLANDALE BEACH BLVD
HALLANDALE BEACH FL
33009-5529
US

IV. Provider business mailing address

6378 NW 170TH LN
HIALEAH FL
33015-4629
US

V. Phone/Fax

Practice location:
  • Phone: 954-454-5777
  • Fax:
Mailing address:
  • Phone: 305-721-5935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11007317
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN9292552
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: