=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528854296
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YAQUELIN REGALADO CHOUZA APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/17/2025
-----------------------------------------------------
Last Update Date | 04/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5545 W 24TH AVE APT 102
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33016-4775
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-633-5923
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5545 W 24TH AVE APT 102
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33016-4775
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-633-5923
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
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 | 11038928
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------