Healthcare Provider Details

I. General information

NPI: 1649947979
Provider Name (Legal Business Name): YAMILE PUPO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2021
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6919 N DALE MABRY HWY STE 220
TAMPA FL
33614-3868
US

IV. Provider business mailing address

6919 N DALE MABRY HWY STE 220
TAMPA FL
33614-3868
US

V. Phone/Fax

Practice location:
  • Phone: 813-738-6692
  • Fax:
Mailing address:
  • Phone: 813-738-6692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11015028
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11015028
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: