Healthcare Provider Details

I. General information

NPI: 1306406301
Provider Name (Legal Business Name): YAIMA LORELY ABREU AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2019
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 SW 73RD ST # 69
SOUTH MIAMI FL
33143-4679
US

IV. Provider business mailing address

32270 SW 196TH AVE
HOMESTEAD FL
33030-5344
US

V. Phone/Fax

Practice location:
  • Phone: 786-662-5465
  • Fax:
Mailing address:
  • Phone: 561-345-4735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN11002908
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: