MEDICARE: YUSDEL CABRERA VILLALOBOS APRN, FNP-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	363LF0000X	Family Nurse Practitioner	11024615	FL

General Provider Information

NPI Number	:	1467150995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YUSDEL CABRERA VILLALOBOS APRN, FNP-C

Provider Business Mailing Address
First Line	:	2724 SW 22ND AVE
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-3912
Country	:	US
Telephone Number	:	786-238-1289
Fax Number	:	239-237-5659

Provider Business Practice Location Address
First Line	:	2724 SW 22ND AVE
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-3912
Country	:	US
Telephone Number	:	786-238-1289
Fax Number	:

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

Provider Enumeration Date	:	02/23/2023
Last Update Date	:	10/17/2024

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