Healthcare Provider Details

I. General information

NPI: 1114600178
Provider Name (Legal Business Name): YOANDRI ENTENZA BELTRAN APRN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 W 49TH PL STE 603
HIALEAH FL
33012-3158
US

IV. Provider business mailing address

14143 SW 53RD ST
MIRAMAR FL
33027-5986
US

V. Phone/Fax

Practice location:
  • Phone: 305-556-1699
  • Fax: 305-556-6610
Mailing address:
  • Phone: 786-925-2938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11027916
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: