MEDICARE: YANIET SOSA PA-C

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	363A00000X	Physician Assistant	PA9113582	FL

General Provider Information

NPI Number	:	1447864392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANIET SOSA PA-C

Provider Business Mailing Address
First Line	:	709 CURTISS PKWY APT 33
Second Line	:
City	:	MIAMI SPRINGS
State	:	FL
Zip	:	33166-7157
Country	:	US
Telephone Number	:	305-215-4871
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 PARK ST
Second Line	:
City	:	MIAMI SPRINGS
State	:	FL
Zip	:	33166-4452
Country	:	US
Telephone Number	:	305-888-2607
Fax Number	:

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

Provider Enumeration Date	:	09/08/2020
Last Update Date	:	03/23/2022

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