MEDICARE: YUMARIS SANTIESTEBAN 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	11034494	FL
2	363LC1500X	Community Health Nurse Practitioner	11034494	FL
3	363LG0600X	Gerontology Nurse Practitioner	11034494	FL
4	363LP2300X	Primary Care Nurse Practitioner	11034494	FL
5	363LW0102X	Women's Health Nurse Practitioner	11034494	FL
6	363LA2200X	Adult Health Nurse Practitioner	11034494	FL

General Provider Information

NPI Number	:	1841021771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YUMARIS SANTIESTEBAN APRN

Provider Business Mailing Address
First Line	:	8414 NW 26TH PL
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33322-2918
Country	:	US
Telephone Number	:	954-842-5946
Fax Number	:

Provider Business Practice Location Address
First Line	:	8414 NW 26TH PL
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33322-2918
Country	:	US
Telephone Number	:	954-842-5946
Fax Number	:

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

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	08/12/2024

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