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NPI Code Detail

MEDICARE: YAITE CORDOVA SANTIESTEBAN FNP

MEDICARE:   YAITE  CORDOVA SANTIESTEBAN  FNP
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
1363LF0000XFamily Nurse Practitioner11030939FL

General Provider Information

NPI Number : 1518723147
Entity Type Code : Individual
Provider Name (Legal Business Name) : YAITE CORDOVA SANTIESTEBAN FNP
Provider Business Mailing Address
First Line : 2841 N OCEAN BLVD APT 507
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33308-7569
Country : US
Telephone Number : 786-603-7193
Fax Number :
Provider Business Practice Location Address
First Line : 2841 N OCEAN BLVD APT 507
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33308-7569
Country : US
Telephone Number : 786-603-7193
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2024
Last Update Date : 02/21/2024

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Directions to “ YAITE CORDOVA SANTIESTEBAN FNP” Practice Location

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