Provider Demographics
NPI:1225729577
Name:LOPEZ, YENILYN
Entity Type:Individual
Prefix:
First Name:YENILYN
Middle Name:
Last Name:LOPEZ
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 1:13216 OLD BISCAYNE DR
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-7410
Mailing Address - Country:US
Mailing Address - Phone:305-979-9523
Mailing Address - Fax:
Practice Address - Street 1:13216 OLD BISCAYNE DR APT 1804
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7410
Practice Address - Country:US
Practice Address - Phone:305-979-9523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide