=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023609351
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YORDANKA MILANES- RUIZ
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/29/2021
-----------------------------------------------------
Last Update Date | 10/05/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18300 NW 62ND AVE STE 100
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33015-8207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-749-6203
-----------------------------------------------------
Fax | 786-520-3173
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18300 NW 62ND AVE STE 100
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33015-8207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-749-6203
-----------------------------------------------------
Fax | 786-520-3173
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APRN11011503
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------