Provider Demographics
NPI:1174001739
Name:QUEVEDO YANEZ, ORLANDO (NP)
Entity Type:Individual
Prefix:
First Name:ORLANDO
Middle Name:
Last Name:QUEVEDO YANEZ
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10201 SW 191ST ST
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7727
Mailing Address - Country:US
Mailing Address - Phone:305-457-3154
Mailing Address - Fax:
Practice Address - Street 1:10201 SW 191ST ST
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-7727
Practice Address - Country:US
Practice Address - Phone:305-457-3154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-04
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9378608363LF0000X
FLAPRN9378608363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily