Provider Demographics
NPI:1508469636
Name:BERNAL MORO, YENIMA (NP)
Entity type:Individual
Prefix:
First Name:YENIMA
Middle Name:
Last Name:BERNAL MORO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14754 SW 173RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-1799
Mailing Address - Country:US
Mailing Address - Phone:786-525-4138
Mailing Address - Fax:
Practice Address - Street 1:9732 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7513
Practice Address - Country:US
Practice Address - Phone:305-221-0660
Practice Address - Fax:305-221-0696
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11009557363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health