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General NPI Number Information
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NPI Number | 1932071107
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Entity Type | Individual
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Provider Name | YANET MEDINA
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Gender | Female
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 9050 PINES BLVD STE 150
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6400
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Country | US
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Telephone | 954-872-0555
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Fax |
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Provider Business Mailing Address
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Address Line | 11700 SW 24TH ST
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City | MIRAMAR
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State | FL
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Zip | 33025-5618
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Country | US
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Telephone | 786-227-9382
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11043770
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License Number State | FL
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