Healthcare Provider Details

I. General information

NPI: 1801266713
Provider Name (Legal Business Name): MS. YADISNAY GUADALUPE GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2015
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 E FLAMINGO RD STE 204
LAS VEGAS NV
89119-5124
US

IV. Provider business mailing address

13776 SW 8TH ST STE 103
MIAMI FL
33184-3030
US

V. Phone/Fax

Practice location:
  • Phone: 702-680-5874
  • Fax:
Mailing address:
  • Phone: 702-742-5496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11037352
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number863426
License Number StateNV
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number863426
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: