Healthcare Provider Details

I. General information

NPI: 1679444061
Provider Name (Legal Business Name): RENAE L YANERO AANP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2216 N CYPRESS BEND DR APT 510
POMPANO BEACH FL
33069-4425
US

IV. Provider business mailing address

2216 N CYPRESS BEND DR APT 510
POMPANO BEACH FL
33069-4425
US

V. Phone/Fax

Practice location:
  • Phone: 954-644-3142
  • Fax:
Mailing address:
  • Phone: 954-644-3142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN11050013
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11050013
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN11050013
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: