Provider Demographics
NPI:1164148474
Name:YEE, MANUEL VERGARA III (FNP)
Entity Type:Individual
Prefix:MR
First Name:MANUEL
Middle Name:VERGARA
Last Name:YEE
Suffix:III
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14091 SW 157TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-6746
Mailing Address - Country:US
Mailing Address - Phone:305-562-8435
Mailing Address - Fax:
Practice Address - Street 1:14091 SW 157TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-6746
Practice Address - Country:US
Practice Address - Phone:305-562-8435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022340363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily