Healthcare Provider Details

I. General information

NPI: 1235133786
Provider Name (Legal Business Name): YVETTE JEAN FLETCHER-PRINCE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2331 N STATE ROAD 7 STE 102
LAUDERDALE LAKES FL
33313-3771
US

IV. Provider business mailing address

2331 N STATE ROAD 7 STE 102
LAUDERDALE LAKES FL
33313-3771
US

V. Phone/Fax

Practice location:
  • Phone: 954-484-8444
  • Fax:
Mailing address:
  • Phone: 954-589-1238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberHSE32374
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN2517192
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: