Healthcare Provider Details

I. General information

NPI: 1083311278
Provider Name (Legal Business Name): YILAIDYS VARGAS APRN-FNP BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2023
Last Update Date: 04/20/2023
Certification Date: 04/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 NE 2ND AVE FL 3
MIAMI FL
33137-2706
US

IV. Provider business mailing address

15267 SW 179TH TER
MIAMI FL
33187-7734
US

V. Phone/Fax

Practice location:
  • Phone: 305-762-3883
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11024431
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: