Provider Demographics
NPI:1396478848
Name:PLASENCIA VIGIL, YONAICRIS DE (APRN)
Entity type:Individual
Prefix:
First Name:YONAICRIS
Middle Name:DE
Last Name:PLASENCIA VIGIL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 NW 84TH TER
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3400
Mailing Address - Country:US
Mailing Address - Phone:786-499-6201
Mailing Address - Fax:
Practice Address - Street 1:450 SW 136 AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027
Practice Address - Country:US
Practice Address - Phone:954-239-4818
Practice Address - Fax:954-751-5044
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11020129363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care