Provider Demographics
NPI:1568203818
Name:PLUTIN SANTOS, YANET (APRN11033111)
Entity type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:PLUTIN SANTOS
Suffix:
Gender:F
Credentials:APRN11033111
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 SW 96TH TER APT 204
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2329
Mailing Address - Country:US
Mailing Address - Phone:561-506-7764
Mailing Address - Fax:
Practice Address - Street 1:1511 FOREST HILL BLVD STE C
Practice Address - Street 2:
Practice Address - City:LAKE CLARKE SHORES
Practice Address - State:FL
Practice Address - Zip Code:33406-6077
Practice Address - Country:US
Practice Address - Phone:561-433-3556
Practice Address - Fax:561-967-5559
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11033111363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily