Healthcare Provider Details

I. General information

NPI: 1285330613
Provider Name (Legal Business Name): YAILADYS VARGAS VIENES APRN MSN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2023
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 MAITLAND CENTER PKWY STE 310
MAITLAND FL
32751-7442
US

IV. Provider business mailing address

10837 SW 242ND ST
HOMESTEAD FL
33032-5140
US

V. Phone/Fax

Practice location:
  • Phone: 352-329-1800
  • Fax: 352-329-1810
Mailing address:
  • Phone: 305-414-3428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11024368
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: