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General NPI Number Information
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NPI Number | 1053053249
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Entity Type | Individual
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Provider Name | YANISE GARCIA GUTIERREZ APRN
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Gender | Female
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Dates
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Enumeration Date | 04/08/2022
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Last Update Date | 04/08/2022
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Provider Practice Location Address
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Address Line | 1874 WEST AVE STE 1
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City | MIAMI BEACH
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State | FL
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Zip | 33139-1432
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Country | US
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Telephone | 786-366-4723
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Fax |
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Provider Business Mailing Address
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Address Line | 488 NE 18TH ST UNIT 717
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City | MIAMI
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State | FL
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Zip | 33132-1291
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Country | US
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Telephone | 786-366-4723
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11019083
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License Number State | FL
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