MEDICARE: YESENIA LICOR DNP

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	367500000X	Certified Registered Nurse Anesthetist	11044600	FL

General Provider Information

NPI Number	:	1912879867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YESENIA LICOR DNP

Provider Business Mailing Address
First Line	:	4300 ALTON RD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2948
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 ALTON RD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2948
Country	:	US
Telephone Number	:	305-432-9321
Fax Number	:

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

Provider Enumeration Date	:	09/20/2025
Last Update Date	:	01/05/2026

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Directions to “ YESENIA LICOR DNP” Practice Location

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