Provider Demographics
NPI:1912590159
Name:PADRON, YANAREIVYS (APRN)
Entity type:Individual
Prefix:
First Name:YANAREIVYS
Middle Name:
Last Name:PADRON
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 1:5450 SW 8TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2200
Mailing Address - Country:US
Mailing Address - Phone:305-967-8381
Mailing Address - Fax:305-967-8394
Practice Address - Street 1:5450 SW 8TH ST STE 202
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2200
Practice Address - Country:US
Practice Address - Phone:305-967-8381
Practice Address - Fax:305-967-8394
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11011628363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily