Provider Demographics
NPI:1992241491
Name:MEDINA, YANELYS (APRN)
Entity type:Individual
Prefix:
First Name:YANELYS
Middle Name:
Last Name:MEDINA
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 1:8181 NW 154TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5861
Mailing Address - Country:US
Mailing Address - Phone:305-558-3724
Mailing Address - Fax:786-260-0018
Practice Address - Street 1:21097 NE 27TH CT STE 410
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1249
Practice Address - Country:US
Practice Address - Phone:305-932-6375
Practice Address - Fax:305-932-9002
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9295326363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily