Healthcare Provider Details

I. General information

NPI: 1174450092
Provider Name (Legal Business Name): ROSANA VICTORIA YANES RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 W 29TH ST
HIALEAH FL
33012-5511
US

IV. Provider business mailing address

1230 W 29TH ST
HIALEAH FL
33012-5511
US

V. Phone/Fax

Practice location:
  • Phone: 305-805-4985
  • Fax:
Mailing address:
  • Phone: 305-805-4985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS70418
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: