Provider Demographics
NPI:1417737180
Name:CARMONA, YURI ERNESTO (APRN)
Entity Type:Individual
Prefix:
First Name:YURI
Middle Name:ERNESTO
Last Name:CARMONA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3683 S MIAMI AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4238
Mailing Address - Country:US
Mailing Address - Phone:855-444-2342
Mailing Address - Fax:
Practice Address - Street 1:3683 S MIAMI AVE STE 500
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4238
Practice Address - Country:US
Practice Address - Phone:855-444-2342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11028902363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care