Healthcare Provider Details

I. General information

NPI: 1649712563
Provider Name (Legal Business Name): JUAN YURI HERRERA ORTHOPAEDIC APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2016
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 E 25TH ST STE 508
HIALEAH FL
33013-3834
US

IV. Provider business mailing address

3540 EVERGLADES BLVD N
NAPLES FL
34120-1566
US

V. Phone/Fax

Practice location:
  • Phone: 305-696-7772
  • Fax:
Mailing address:
  • Phone: 786-715-6978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0800X
TaxonomyOrthopedic Registered Nurse
License NumberAPRN9404039
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN9404039
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9404039
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: