Healthcare Provider Details

I. General information

NPI: 1346670494
Provider Name (Legal Business Name): YDANIA SANTACLARA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2013
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1865 NE 163RD ST
NORTH MIAMI BEACH FL
33162-4805
US

IV. Provider business mailing address

8749 W 37TH AVE APT 303
HIALEAH FL
33018-2290
US

V. Phone/Fax

Practice location:
  • Phone: 786-261-8872
  • Fax:
Mailing address:
  • Phone: 786-261-8872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9339483
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9339483
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: