Healthcare Provider Details

I. General information

NPI: 1730731340
Provider Name (Legal Business Name): ISABEL K. YAGUE ARNP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2019
Last Update Date: 07/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2461 SW 84TH AVE
MIAMI FL
33155-2458
US

IV. Provider business mailing address

2461 SW 84TH AVE
MIAMI FL
33155-2458
US

V. Phone/Fax

Practice location:
  • Phone: 786-351-0167
  • Fax: 305-402-0941
Mailing address:
  • Phone: 786-351-0167
  • Fax: 305-402-0941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. ISABEL KARINA YAGUE
Title or Position: OWNER
Credential: APRN
Phone: 786-351-0167