Healthcare Provider Details

I. General information

NPI: 1063343168
Provider Name (Legal Business Name): YENISLEIDYS ELSA TAMAYO FORNARIS MSN, APRN, FPN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 BRANDYWINE RD APT 600I
WEST PALM BEACH FL
33409-2050
US

IV. Provider business mailing address

1441 BRANDYWINE RD APT 600I
WEST PALM BEACH FL
33409-2050
US

V. Phone/Fax

Practice location:
  • Phone: 786-370-5308
  • Fax:
Mailing address:
  • Phone: 786-370-5308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number689470
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: