MEDICARE: YAMILDA BASSOLS-PORRO

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11025989	FL
2	363LF0000X	Family Nurse Practitioner	APRN11025989	FL

General Provider Information

NPI Number	:	1386336865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAMILDA BASSOLS-PORRO

Provider Business Mailing Address
First Line	:	882 W 79TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-3536
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	882 W 79TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-3536
Country	:	US
Telephone Number	:	786-486-2437
Fax Number	:

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

Provider Enumeration Date	:	05/23/2023
Last Update Date	:	01/08/2026

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Directions to “ YAMILDA BASSOLS-PORRO ” Practice Location

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