Healthcare Provider Details

I. General information

NPI: 1811826258
Provider Name (Legal Business Name): YENESI CRISTINE ROSARIO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2718 W ROSCOE ST
CHICAGO IL
60618-5910
US

IV. Provider business mailing address

4299 SOUTHERN VISTA LOOP
SAINT CLOUD FL
34772-6880
US

V. Phone/Fax

Practice location:
  • Phone: 954-483-6597
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11047344
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: