Provider Demographics
NPI:1154837623
Name:JORDANA, YONAISA (NP-C)
Entity Type:Individual
Prefix:
First Name:YONAISA
Middle Name:
Last Name:JORDANA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:YONAISA
Other - Middle Name:
Other - Last Name:PORTALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3352 SW 110TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3562
Mailing Address - Country:US
Mailing Address - Phone:305-606-8777
Mailing Address - Fax:
Practice Address - Street 1:654 NE 9TH PL
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030
Practice Address - Country:US
Practice Address - Phone:305-248-3488
Practice Address - Fax:305-248-6558
Is Sole Proprietor?:No
Enumeration Date:2017-12-20
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9234740363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology