MEDICARE: YELENA M SORRELL APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11001023	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225688435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YELENA M SORRELL APRN

Provider Business Mailing Address
First Line	:	3420 W 100TH TER
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-2103
Country	:	US
Telephone Number	:	786-252-6004
Fax Number	:

Provider Business Practice Location Address
First Line	:	3420 W 100TH TER
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-2103
Country	:	US
Telephone Number	:	786-252-6004
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2019
Last Update Date	:	09/19/2019

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