Healthcare Provider Details

I. General information

NPI: 1073184537
Provider Name (Legal Business Name): YANARA GALAN CHARLON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2021
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 OPA LOCKA BLVD
OPA LOCKA FL
33054-3526
US

IV. Provider business mailing address

6100 BLUE LAGOON DR STE 365
MIAMI FL
33126-7010
US

V. Phone/Fax

Practice location:
  • Phone: 786-476-3333
  • Fax: 786-621-7816
Mailing address:
  • Phone: 786-322-7333
  • Fax: 786-322-7349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11014105
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: