Provider Demographics
NPI:1033698238
Name:SIERRA DOMINGUEZ, YOLAINE
Entity Type:Individual
Prefix:
First Name:YOLAINE
Middle Name:
Last Name:SIERRA DOMINGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 W FLAGLER ST APT 6
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1566
Mailing Address - Country:US
Mailing Address - Phone:786-474-1354
Mailing Address - Fax:
Practice Address - Street 1:4440 W FLAGLER ST APT 6
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1566
Practice Address - Country:US
Practice Address - Phone:786-474-1354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9412292363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily