Provider Demographics
NPI:1154906485
Name:RODRIGUEZ LEVY, YANITSIRC (FNP)
Entity type:Individual
Prefix:
First Name:YANITSIRC
Middle Name:
Last Name:RODRIGUEZ LEVY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9725 NW 117TH AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1212
Mailing Address - Country:US
Mailing Address - Phone:954-432-0578
Mailing Address - Fax:954-432-5060
Practice Address - Street 1:6517 TAFT ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-4062
Practice Address - Country:US
Practice Address - Phone:954-218-5751
Practice Address - Fax:866-513-3988
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-17
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11015010363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily