Healthcare Provider Details

I. General information

NPI: 1295909976
Provider Name (Legal Business Name): YOVANIT FAJARDO AQUINO DNM, FNP-BC, ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 NW 4TH ST STE 5
MIAMI FL
33125-4854
US

IV. Provider business mailing address

6880 TAMIAMI CANAL RD
MIAMI FL
33126-4451
US

V. Phone/Fax

Practice location:
  • Phone: 305-569-4060
  • Fax: 305-646-6757
Mailing address:
  • Phone: 786-326-7504
  • Fax: 350-235-3742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9339362
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: