Provider Demographics
NPI:1932922291
Name:RODRIGUEZ, YANDY A (MSN, APRN, AGACNP-BC)
Entity type:Individual
Prefix:MR
First Name:YANDY
Middle Name:A
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MSN, APRN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 292883
Mailing Address - Street 2:3850 S UNIVERSITY DR #292883
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33329-2883
Mailing Address - Country:US
Mailing Address - Phone:954-853-5120
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 292883
Practice Address - Street 2:3850 S UNIVERSITY DR #292883
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33329-2883
Practice Address - Country:US
Practice Address - Phone:954-853-5120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-05
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11036367363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty