Provider Demographics
NPI:1306406301
Name:ABREU, YAIMA LORELY (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:YAIMA
Middle Name:LORELY
Last Name:ABREU
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26103 SW 136TH CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-2579
Mailing Address - Country:US
Mailing Address - Phone:561-345-4735
Mailing Address - Fax:
Practice Address - Street 1:26103 SW 136TH CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-2579
Practice Address - Country:US
Practice Address - Phone:561-345-4735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11002908363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care