MEDICARE: MS. YARENIS ALONSO 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	363L00000X	Nurse Practitioner	APRN11010681	FL
2	367500000X	Certified Registered Nurse Anesthetist	APRN11010681	FL
3	363LF0000X	Family Nurse Practitioner	APRN11010681	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	:	1598353542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. YARENIS ALONSO APRN

Provider Business Mailing Address
First Line	:	6400 SHAFER CT STE 700
Second Line	:
City	:	ROSEMONT
State	:	IL
Zip	:	60018-4989
Country	:	US
Telephone Number	:	346-376-1702
Fax Number	:	224-532-2780

Provider Business Practice Location Address
First Line	:	4850 ALLEN RD # 1022
Second Line	:
City	:	ZEPHYRHILLS
State	:	FL
Zip	:	33541-3551
Country	:	US
Telephone Number	:	844-723-1725
Fax Number	:

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

Provider Enumeration Date	:	01/05/2021
Last Update Date	:	04/25/2024

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