Healthcare Provider Details

I. General information

NPI: 1841942166
Provider Name (Legal Business Name): YOELQUIS RODRIGUEZ APRN-FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2022
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4980 W 10TH AVE
HIALEAH FL
33012-3437
US

IV. Provider business mailing address

1400 NW 107TH AVE STE 500
SWEETWATER FL
33172-2746
US

V. Phone/Fax

Practice location:
  • Phone: 305-534-0076
  • Fax:
Mailing address:
  • Phone: 305-534-0076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11017563
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: