Healthcare Provider Details

I. General information

NPI: 1154210110
Provider Name (Legal Business Name): YANELYS DUARTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2025
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17152 SW 137TH CT
MIAMI FL
33177-6499
US

IV. Provider business mailing address

17152 SW 137TH CT
MIAMI FL
33177-6499
US

V. Phone/Fax

Practice location:
  • Phone: 786-362-2007
  • Fax:
Mailing address:
  • Phone: 786-362-2007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberPS61439
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: