Provider Demographics
NPI:1376285429
Name:LEAL CONCEPCION, YANET I (ARNP)
Entity Type:Individual
Prefix:MISS
First Name:YANET
Middle Name:
Last Name:LEAL CONCEPCION
Suffix:I
Gender:F
Credentials:ARNP
Other - Prefix:MISS
Other - First Name:YANET
Other - Middle Name:LEAL
Other - Last Name:CONCEPCION
Other - Suffix:I
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:2730 NE 4TH ST UNIT 102
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-7073
Mailing Address - Country:US
Mailing Address - Phone:305-338-5506
Mailing Address - Fax:
Practice Address - Street 1:2730 NE 4TH ST UNIT 102
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7073
Practice Address - Country:US
Practice Address - Phone:305-338-5506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-10
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11019089363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner