Healthcare Provider Details

I. General information

NPI: 1316691934
Provider Name (Legal Business Name): ADILYS YANES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2022
Last Update Date: 02/11/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

13086 SW 196TH ST
MIAMI FL
33177-4285
US

V. Phone/Fax

Practice location:
  • Phone: 786-662-5465
  • Fax:
Mailing address:
  • Phone: 305-733-4152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN11018081
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: